Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose
Calcium channel blocker (CCB) toxicity carries a high mortality and is the sixth most fatal drug class reported to US poison centers. Amlodipine overdose is characterized by a life-threatening arterial vasodilation that compromises organ perfusion. The management of CCB intoxication is focused on ma...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
EDP Sciences
2023-12-01
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| Series: | The Journal of ExtraCorporeal Technology |
| Subjects: | |
| Online Access: | https://ject.edpsciences.org/articles/ject/full_html/2023/04/ject230039/ject230039.html |
| _version_ | 1797294811445723136 |
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| author | Cardenas Jose M. Borasino Santiago Timpa Joseph Hawkins Jeremy McBride Martha Rushton William Newman Jordan Mendoza Erika Sorabella Robert Byrnes Jonathan |
| author_facet | Cardenas Jose M. Borasino Santiago Timpa Joseph Hawkins Jeremy McBride Martha Rushton William Newman Jordan Mendoza Erika Sorabella Robert Byrnes Jonathan |
| author_sort | Cardenas Jose M. |
| collection | DOAJ |
| description | Calcium channel blocker (CCB) toxicity carries a high mortality and is the sixth most fatal drug class reported to US poison centers. Amlodipine overdose is characterized by a life-threatening arterial vasodilation that compromises organ perfusion. The management of CCB intoxication is focused on maintaining adequate organ perfusion. In cases refractory to medical therapies, hemodynamic support with extracorporeal membrane oxygenation (ECMO) is warranted necessitating higher flows than usual to compensate for the vasodilation and requiring central cannulation. We present a case of a 12-year-old with severe dihydropyridine CCB ingestion, refractory to medical management and successfully treated with central ECMO cannulation. The patient was discharged home with no significant disability. Central ECMO cannulation may be helpful to facilitate adequate flows in vasodilatory shock such as CCB overdose. |
| first_indexed | 2024-03-07T21:37:11Z |
| format | Article |
| id | doaj.art-0d3d248b1e6d4706b92056494b916892 |
| institution | Directory Open Access Journal |
| issn | 0022-1058 2969-8960 |
| language | English |
| last_indexed | 2024-03-07T21:37:11Z |
| publishDate | 2023-12-01 |
| publisher | EDP Sciences |
| record_format | Article |
| series | The Journal of ExtraCorporeal Technology |
| spelling | doaj.art-0d3d248b1e6d4706b92056494b9168922024-02-26T11:28:11ZengEDP SciencesThe Journal of ExtraCorporeal Technology0022-10582969-89602023-12-0155420620810.1051/ject/2023037ject230039Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdoseCardenas Jose M.0https://orcid.org/0000-0001-7354-3194Borasino Santiago1Timpa Joseph2Hawkins Jeremy3McBride Martha4Rushton William5Newman Jordan6Mendoza Erika7Sorabella Robert8Byrnes Jonathan9Division of Pediatric Cardiology Section of Cardiac Critical Care. University of Alabama at Birmingham School of MedicineDivision of Pediatric Cardiology Section of Cardiac Critical Care. University of Alabama at Birmingham School of MedicineECMO Clinical Coordinator Children’s of AlabamaDepartment of Cardiovascular Perfusion Children’s of AlabamaECMO Clinical Coordinator Children’s of AlabamaDepartment of Pediatric Emergency Medicine. University of Alabama at Birmingham School of MedicineDepartment of Pediatric Critical Care. University of Alabama at Birmingham School of MedicineDivision of Pediatric Cardiology Section of Cardiac Critical Care. University of Alabama at Birmingham School of MedicineDivision of Pediatric Cardiology Section of Cardiac Critical Care. University of Alabama at Birmingham School of MedicineDivision of Pediatric Cardiology Section of Cardiac Critical Care. University of Alabama at Birmingham School of MedicineCalcium channel blocker (CCB) toxicity carries a high mortality and is the sixth most fatal drug class reported to US poison centers. Amlodipine overdose is characterized by a life-threatening arterial vasodilation that compromises organ perfusion. The management of CCB intoxication is focused on maintaining adequate organ perfusion. In cases refractory to medical therapies, hemodynamic support with extracorporeal membrane oxygenation (ECMO) is warranted necessitating higher flows than usual to compensate for the vasodilation and requiring central cannulation. We present a case of a 12-year-old with severe dihydropyridine CCB ingestion, refractory to medical management and successfully treated with central ECMO cannulation. The patient was discharged home with no significant disability. Central ECMO cannulation may be helpful to facilitate adequate flows in vasodilatory shock such as CCB overdose.https://ject.edpsciences.org/articles/ject/full_html/2023/04/ject230039/ject230039.htmlecmo (extracorporeal membrane oxygenation)shockperipheral vascular diseasepediatricpharmacologycardiovascular |
| spellingShingle | Cardenas Jose M. Borasino Santiago Timpa Joseph Hawkins Jeremy McBride Martha Rushton William Newman Jordan Mendoza Erika Sorabella Robert Byrnes Jonathan Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose The Journal of ExtraCorporeal Technology ecmo (extracorporeal membrane oxygenation) shock peripheral vascular disease pediatric pharmacology cardiovascular |
| title | Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose |
| title_full | Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose |
| title_fullStr | Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose |
| title_full_unstemmed | Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose |
| title_short | Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose |
| title_sort | central ecmo cannulation for severe dihydropyridine calcium channel blocker overdose |
| topic | ecmo (extracorporeal membrane oxygenation) shock peripheral vascular disease pediatric pharmacology cardiovascular |
| url | https://ject.edpsciences.org/articles/ject/full_html/2023/04/ject230039/ject230039.html |
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