Citation

Ho A, Go A, Barrios C, Scalzo A. Case Rep. Crit. Care 2020; 2020.

Copyright

(Copyright © 2020, Hindawi Publishing)

DOI

10.1155/2020/8842303

PMID

unavailable

Abstract

Calcium channel blocker (CCB) poisoning frequently presents with cardiovascular complications such as cardiogenic shock and arrhythmia. We present a case of massive verapamil overdose causing refractory noncardiogenic pulmonary edema successfully treated with extracorporeal membrane oxygenation. To our knowledge, this is the first case with these features reported in literature. A 27-year-old female patient presented with an overdose of 18,000 mg of verapamil. Her clinical condition deteriorated to severe hypoxic respiratory failure despite being treated with calcium, high-dose insulin, and full invasive ventilation support. She eventually required venovenous extracorporeal membrane oxygenation (VV-ECMO) for three days with full recovery. Large ingestion of verapamil could lead to noncardiogenic pulmonary edema. VV-ECMO might play an important role to support the treatment in severe cases with refractory hypoxia. © 2020 An Ho et al.

Language: en

Keywords

adult; human; female; resuscitation; case report; depression; suicide attempt; drug overdose; vomiting; clinical article; length of stay; psychiatric department; noradrenalin; activated carbon; hypotension; asthma; drug megadose; atropine; bicarbonate; cardiopulmonary arrest; insulin; dobutamine; oxygen; glucagon; infusion fluid; hypoxia; calcium; adult respiratory distress syndrome; thorax radiography; verapamil; Article; diuretic agent; arterial gas; prostacyclin; hypoxemia; acute respiratory failure; neuromuscular blocking agent; arterial oxygen tension; hypertensive factor; insulin infusion; neuromuscular blocking; return of spontaneous circulation; cisatracurium; epinephrine; invasive ventilation; medical intensive care unit; noncardiogenic lung edema; positive end expiratory pressure ventilation; veno-venous ECMO