Hui Wun Fung, Choi Ann Wing Man, Cheung Wing Lum, Hon Kam Lun, Ku Shu Wing
Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong.
Semin Dial. 2025 Mar-Apr;38(2):146-151. doi: 10.1111/sdi.13236. Epub 2024 Dec 24.
We report the successful application of single pass albumin dialysis (SPAD) and hemoadsorption (HA) in two teenagers with amlodipine poisoning. A 16-year-old girl with amlodipine overdose developed refractory shock and lactic acidosis despite multiple inotropes, calcium, insulin, and glucagon infusion. SPAD was initiated 18 h after the incident for 21 h. She improved dramatically and was able to wean off all inotropes 54 h after admission. Another 16-year-old girl required extracorporeal membrane oxygenation (ECMO) support after deliberate consumption of 1100-mg amlodipine. SPAD was initiated 13 h after the incident for 38 h, followed by two more sessions of HA using the Cytosorb column. All inotropes were stopped 18 h after terminating the HA, and ECMO was weaned off 28 h later. There were no major complications during the therapy. Our cases demonstrated that early extracorporeal removal can be considered as an adjunctive therapy in children with life-threatening amlodipine overdose.
我们报告了单通道白蛋白透析（SPAD）和血液吸附（HA）在两名氨氯地平中毒青少年中的成功应用。一名16岁氨氯地平过量的女孩尽管多次输注血管活性药物、钙剂、胰岛素和胰高血糖素，仍出现难治性休克和乳酸性酸中毒。事件发生18小时后开始进行单通道白蛋白透析21小时。她病情显著改善，入院54小时后能够停用所有血管活性药物。另一名16岁女孩在故意服用1100毫克氨氯地平后需要体外膜肺氧合（ECMO）支持。事件发生13小时后开始进行单通道白蛋白透析38小时，随后使用Cytosorb柱再进行两次血液吸附治疗。在血液吸附治疗结束18小时后停用所有血管活性药物，28小时后停用体外膜肺氧合。治疗期间无重大并发症。我们的病例表明，对于危及生命的氨氯地平过量儿童，早期体外清除可作为辅助治疗手段。
