Omar Shahed, Shukla Varadaben, Khan Ayesha B, Dangor Ziyaad
Department of Critical Care, University of the Witwatersrand, Johannesburg, South Africa.
Vaccines and Infectious Diseases Analytics Research Unit (VIDA)/University of Witwatersrand/Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Indian J Crit Care Med. 2025 Feb;29(2):130-136. doi: 10.5005/jp-journals-10071-24906. Epub 2025 Jan 31.
To describe the burden of calcium channel blocker (CCB) overdose at a tertiary intensive care unit (ICU).
Retrospective study of patients admitted to the ICU with CCB overdose from 2020 to 2022.
Adult participants with clinically confirmed CCB overdose.
Admission frequency, management strategies, and patient outcomes.
A total of 1719 ICU admissions over the study period, 24 (1.4%) had CCB overdose with a case fatality rate of 12.5% (3/24). Interventions included mechanical ventilation (MV) (71%), vasopressors (92%), high-dose insulin euglycemic therapy (HIET) (71%), calcium (42%), methylene blue (4%), and fluid therapy (100%). Thirteen patients (54%) received hemoadsorption therapy (HA), and eleven received standard of care (SoC) based on current guidelines. The resin hemoadsorption group had a higher SAPS II score ( = 0.002), and a greater total maximal vasopressor dose ( = 0.001) than SoC group. The HA group also had a lower admission mean arterial pressure (MAP), ( = 0.014), a greater MAP increase at 48 hours ( = 0.044), and a longer ICU length of stay (LOS) ( = 0.004) compared to the SoC group. There was one death in the HA group (7.7%) and two in the SoC group (18.2%).
Calcium channel blocker overdose is an important and life-threatening cause of toxicology admissions in the ICU. Modern resin HA may contribute to improved hemodynamic stability providing a safe and important rescue therapy in cases with refractory shock. Well-designed studies are required to confirm its role in enhancing drug clearance thereby improving the hemodynamic state and clinical outcomes.
Omar S, Shukla V, Khan AB, Dangor Z. Hemoadsorption Therapy for Calcium Channel Blocker Overdose at a Tertiary-level Intensive Care Unit: A Retrospective Study. Indian J Crit Care Med 2025;29(2):130-136.
描述三级重症监护病房（ICU）中钙通道阻滞剂（CCB）过量的负担。
对2020年至2022年入住ICU且CCB过量的患者进行回顾性研究。
临床确诊为CCB过量的成年患者。
入院频率、管理策略及患者结局。
在研究期间，ICU共收治1719例患者，其中24例（1.4%）为CCB过量，病死率为12.5%（3/24）。干预措施包括机械通气（MV）（71%）、血管升压药（92%）、高剂量胰岛素血糖正常化治疗（HIET）（71%）、钙剂（42%）、亚甲蓝（4%）及液体治疗（100%）。13例患者（54%）接受血液吸附治疗（HA），11例根据现行指南接受标准治疗（SoC）。树脂血液吸附组的序贯器官衰竭评估（SOFA）II评分更高（P = 0.002），血管升压药总最大剂量更大（P = 0.001）。与SoC组相比，HA组入院时平均动脉压（MAP）更低（P = 0.014），48小时时MAP升高幅度更大（P = 0.044），ICU住院时间（LOS）更长（P = 0.004）。HA组有1例死亡（7.7%），SoC组有2例死亡（18.2%）。
钙通道阻滞剂过量是ICU中毒理学入院的一个重要且危及生命的原因。现代树脂HA可能有助于改善血流动力学稳定性，为难治性休克患者提供一种安全且重要的抢救治疗。需要设计良好的研究来证实其在增强药物清除从而改善血流动力学状态和临床结局方面的作用。
Omar S, Shukla V, Khan AB, Dangor Z. 三级重症监护病房钙通道阻滞剂过量的血液吸附治疗：一项回顾性研究。《印度重症监护医学杂志》2025；29(2):130 - 136。 （注：原文中部分SAPS II应改为SAPS II，属于原文错误，翻译时按照正确内容翻译，同时补充了SOFA全称为序贯器官衰竭评估，属于对医学术语的完整补充，以便更好理解译文）
