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静脉用脂肪乳治疗钙通道阻滞剂中毒危重症患儿的效果。

Effect of intravenous lipid therapy in critically ill pediatric patients with calcium channel blocker toxicity.

机构信息

Department of Pediatric Intensive Care Unit, Batman Education and Research Hospital, Batman, Türkiye.

出版信息

Turk J Pediatr. 2024;66(1):75-80. doi: 10.24953/turkjped.2023.543.

Abstract

BACKGROUND

Overdose with calcium-channel blockers (CCBs) still maintain their importance with a high lethality rate after exposure. We report the intravenous lipid emulsion therapy (ILE) therapy in our CCB overdose patients.

METHODS

We retrospectively analyzed the records of 6 patients with CCB intoxication from Batman Training and Research Hospital PICU between March 2021 and September 2022. Patients aged 0-18 years who received ILE treatment for CCB poisoning were included.

RESULTS

All six patients ingested CCB with the intention of committing suicide and were followed up in the pediatric intensive care unit (PICU). All patients received ILE therapy due to hemodynamic instability despite intravenous fluid boluses, calcium, glucagon, insulin-dextrose, and vasoactive agents. Vasoactive-Inotropic Score (VIS) decreased after ILE treatment. All patients were transferred from the PICU after recovery.

CONCLUSIONS

ILE therapy should be kept in mind as a salvage therapy in hemodynamically unstable CCB poisoning cases that do not respond to initial and advanced options.

摘要

背景

钙通道阻滞剂(CCB)过量后,即使经过治疗,其死亡率仍然很高,因此仍需重视。我们报告了几例 CCB 过量患者采用静脉用脂肪乳剂治疗(ILE)的情况。

方法

我们回顾性分析了 2021 年 3 月至 2022 年 9 月期间 Batman 培训和研究医院儿科重症监护病房(PICU)收治的 6 例 CCB 中毒患者的记录。本研究纳入了因 CCB 中毒接受 ILE 治疗且年龄在 0-18 岁的患者。

结果

所有 6 例患者均因自杀意图摄入 CCB,并在儿科重症监护病房(PICU)接受了随访。所有患者均因血管活性药物治疗后仍存在血流动力学不稳定,尽管接受了静脉补液、钙剂、胰高血糖素、胰岛素-葡萄糖和血管活性药物治疗。ILE 治疗后血管活性-正性肌力评分(VIS)降低。所有患者在恢复后均从 PICU 转出。

结论

对于初始和高级治疗方案无效的血流动力学不稳定的 CCB 中毒患者,ILE 治疗应作为一种挽救性治疗方法。

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