Persad Elizabeth A, Raman Lakshmi, Thompson Marita T, Sheeran Paul W
University of Texas Southwestern, Dallas, Texas, USA.
Indian J Crit Care Med. 2012 Oct;16(4):204-6. doi: 10.4103/0972-5229.106502.
Calcium channel blocker (CCB) toxicity is associated with refractory hypotension and can be fatal. A 13 year old young woman presented to the emergency department(ED) six hours after an intentional overdose of amlodipine, barbiturates, and alcohol. She remained extremely hypotensive despite the administration of normal saline and calcium chloride and despite infusions of norepinephrine, epinephrine, insulin, and dextrose. Due to increasing evidence of end organ dysfunction, Extracorporeal Life Support (ECLS) was initiated 9 hours after presentation to the ED. The patient's blood pressure and end organ function immediately improved after cannulation. She was successfully decannulated after 57 hours of ECLS and was neurologically intact. Patients with calcium channel blocker overdose who are resistant to medical interventions may respond favorably to early ECLS.
钙通道阻滞剂(CCB)中毒与难治性低血压相关,且可能致命。一名13岁年轻女性在故意过量服用氨氯地平、巴比妥类药物和酒精6小时后被送往急诊科。尽管给予了生理盐水、氯化钙,以及输注去甲肾上腺素、肾上腺素、胰岛素和葡萄糖,她的血压仍极低。由于有越来越多的证据表明存在终末器官功能障碍,在该患者被送往急诊科9小时后启动了体外生命支持(ECLS)。插管后患者的血压和终末器官功能立即得到改善。在接受ECLS 57小时后,她成功拔管,且神经功能完好。对药物干预有抵抗的钙通道阻滞剂过量患者可能对早期ECLS反应良好。