Severe Hypertension Following Accidental Clonidine Overdose During the Refilling of an Implanted Intrathecal Drug Delivery System

Perruchoud, Christophe; Bovy, Michèle; Durrer, Anne; Rosato, Marilu; Rutschmann, B.; Mustaki, Jean-Pierre; Buchser, Eric

doi:10.1111/j.1525-1403.2011.00392.x

Cited by 24 publications

(21 citation statements)

References 20 publications

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“…Another clinical study in healthy volunteers reported an 80% increase in systemic vascular resistance following supratherapeutic dexmedetomidine doses (13). These observations are in line with clinical reports on severe arterial hypertension following inadvertent overdoses of a,-agonists ( 14,15). In addition, a^-agonists can interfere with the baroreceptor reflex (changes in heart rate in response to changes in arterial pressure) through central mechanisms.…”

mentioning

confidence: 56%

α2-Agonists to Restore Adrenergic Vasoconstrictor Responsiveness in Septic Shock

Dünser

Gradwohl-Matis²

2013

Critical Care Medicine

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Editorial atelectrauma from overdistension injury. Bronchiolar damage may well be a histological marker of atelectrauma.What does the study by Park et al (5) teach us? First, it suggests that even transient losses of airway pressure may frustrate valiant attempts at lung recruitment. Whether complete avoidance of transient derecruitment is a valuable or even feasible, clinical goal remains to be seen. The confusing but very interesting issue of injury location highlights the fact that until the day we really understand the fine detail of what does-or does nothappen at the level of the most distal airspaces, lung recruitment should not be globally declared a lung protective strategy. 2. Caironi P, Cressoni M, Chiumello D, et al: Lung opening and closing during ventilation of acute respiratory distress syndrome. Am J Respir Crit Care Med 2010; 181:578-586 3. Briel M, Meade M, Mercat A, et al: Higher vs \ovjer positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: Systematic review and meta-analysis. JAMA 2010; 303:865-873 4. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. The acute respiratory distress syndrome network. N Engl J Med

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mentioning

confidence: 56%

α2-Agonists to Restore Adrenergic Vasoconstrictor Responsiveness in Septic Shock

Dünser

Gradwohl-Matis²

2013

Critical Care Medicine

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“…[93][94][95] This elevation in blood pressure, thought to be due to peripheral a 1 -and a 2 -AR agonism, is usually transient, asymptomatic, and does not require treatment. The degree of hypertension is correlated with the significance of the exposure, and higher serum concentrations better correlate with development of hypertension.…”

Section: Clinical Manifestationsmentioning

confidence: 97%

Cardiotoxicodynamics

Menke

Walsh

King

2015

Emergency Medicine Clinics of North America

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“…Mechanical complications appear to be the most common ] referred to a number of recommendations and established a diagnostic-therapeutic decision algorithm focusing on the importance of imaging in the detection of these masses (MRI or computed tomography myelogram) and the assessment of neurological signs and symptoms shown by patients when deciding to remove intrathecal catheters or not [35 && ]. A human error wherein accidental clonidine overdose occurred during the refilling of an implanted IDDS resulted in severe hypertension [39]. A human error wherein accidental clonidine overdose occurred during the refilling of an implanted IDDS resulted in severe hypertension [39].…”

Section: Complicationsmentioning

confidence: 99%