We believe our report may contribute to the early use of ILE therapy for toxicity with calcium channel blockers such as verapamil in pediatric patients.
📌 3 Key Takeaways
🎯
Objective & Hypothesis:In recent years, intravenous lipid emulsion therapy (ILE) was used for lipophilic drug intoxications, and successful results were obtained.
📊
Key Findings & Data:We used ILE therapy in a 14‑year‑old girl with verapamil intoxication in the 2nd h of the pediatric intensive care unit stay, before using traditional treatments such as glucagon and hyperinsulinemic euglycemia.
💡
Conclusion & Impact:We believe our report may contribute to the early use of ILE therapy for toxicity with calcium channel blockers such as verapamil in pediatric patients.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters
Özet
In recent years, intravenous lipid emulsion therapy (ILE) was used for lipophilic drug intoxications, and successful results were obtained. In the literature, there is a small number of reported cases about verapamil intoxication and ILE therapy in the pediatric age group. We used ILE therapy in a 14‑year‑old girl with verapamil intoxication in the 2nd h of the pediatric intensive care unit stay, before using traditional treatments such as glucagon and hyperinsulinemic euglycemia. She had resistant bradycardia and hypotension which was unresponsive to inotropic agents and a successful result was obtained after using ILE treatment. We believe our report may contribute to the early use of ILE therapy for toxicity with calcium channel blockers such as verapamil in pediatric patients.
🔖
Cite This Article
HAVAN, M., KENDİRLİ, T., ÖZCAN, S., DOĞAN, M. T., YİĞİT, A. O., UÇAR, T. (2021). A successful treatment with intravenous lipid emulsion therapy in a child with verapamil poisoning. Turkish journal of emergency medicine (Online), Cilt: 21 - Sayı: 4, 217–220. https://ajindex.com/articles/417312
Weinberg GL, VadeBoncouer T, Ramaraju GA, Garcia-Amaro MF, Cwik MJ. Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats. Anesthesiology 1998;88:1071-5
Robben JH, Dijkman MA. Lipid therapy for intoxications. Vet Clin North Am Small Anim Pract 2017;47:435-50
Jamaty C, Bailey B, Larocque A, Notebaert E, Sanogo K, Chauny JM. Lipid emulsions in the treatment of acute intoxication: A systematic review of human and animal studies. Clin Toxicol 2010;48:1-27
Young AC, Velez LI, Kleinschmidt KC. Intravenous fat emulsion therapy for intentional sustained-release verapamil overdose. Resuscitation 2009;80:591-3
Hofer CA, Smith JK, Tenholder MF. Verapamil intoxication: A literature review of overdoses and discussion of therapeutic options. Am J Med 1993;95:431-8
Shepherd G, Klein-Schwartz W. High-dose insulin therapy for calcium-channel blocker overdose. Ann Pharmacother 2005;39:923-30
Kryshtal DO, Dawling S, Seger D, Knollmann BC. In vitro studies indicate intravenous lipid emulsion acts as lipid sink in verapamil poisoning. J Med Toxicol 2016;12:165-71
Aaronson PM, Wassil K, Kunisaki TA. Hyperinsulinemic euglycemia, continuous venovenous hemofiltration, and extracorporeal life support for severe verapamil poisoning: Case report. Clin Toxicol 2009;47:742
Franxman TJ, Al-Nabhan M, Cavallazzi RS, Speak AJ. Lipid emulsion therapy for verapamil overdose. Ann Intern Med 2011;154:292
Liang CW, Diamond SJ, Hagg DS. Lipid rescue of massive verapamil overdose: A case report. J Med Case Rep 2011;5:399
French D, Armenian P, Ruan W, Wong A, Drasner K, Olson KR, et al. Serum verapamil concentrations before and after Intralipid® therapy during treatment of an overdose. Clin Toxicol (Phila) 2011;49:340-4
Martin C, Gonzalez H, Ruiz S, Ribes D, Franchitto N, Minville V. Acute respiratory distress syndrome following verapamil overdose treated with intravenous lipid emulsion: A rare life-threatening complication. Ann Fr Anesth Reanim 2014;33:e101-2
Sampson CS, Bedy SM. Lipid emulsion therapy given intraosseously in massive verapamil overdose. Am J Emerg Med 2015;33:1844.e1
Presley JD, Chyka PA. Intravenous lipid emulsion to reverse acute drug toxicity in pediatric patients. Ann Pharmacother 2013;47:735-43.