Home
|
Inbox
|
Search
|
View Abstract
Intravenous Lipid Emulsion for Cardiac Arrest and Refractory Shock Caused by Intentional Propranolol Overdose: A Human Case Report
Description
.abstract img { width:300px !important; height:auto; display:block; text-align:center; margin-top:10px } .abstract { overflow-x:scroll } .abstract table { width:100%; display:block; border:hidden; border-collapse: collapse; margin-top:10px } .abstract td, th { border-top: 1px solid #ddd; padding: 4px 8px; } .abstract tbody tr:nth-child(even) td { background-color: #efefef; } .abstract a { overflow-wrap: break-word; word-wrap: break-word; }
A6894 - Intravenous Lipid Emulsion for Cardiac Arrest and Refractory Shock Caused by Intentional Propranolol Overdose: A Human Case Report
Author Block: J. Amayo1, K. Horton2, J. D. Butler3; 1Division of Pulmonary, Critical Care and Sleep Medicine, Piedmont Healthcare, Atlanta, GA, United States, 2Emergency Medicine Pharmacy Department, Piedmont Healthcare, Stockbridge, GA, United States, 3Piedmont Healthcare - Division of Pulmonary, Critical Care and Sleep Medicine, Atlanta, GA, United States.
BACKGROUND: Propranolol is a highly lipophilic, non-cardioselective beta blocker. There is a paucity of data for the use of IV lipid emulsion for propranolol toxicity. We describe a case of propranolol overdose associated with cardiovascular collapse and subsequent cardiopulmonary arrest which was treated with IV lipid emulsion.
CASE REPORT: A 28-year-old female ingested an unknown amount of propranolol in addition to ethanol, ibuprofen, aspirin and acetaminophen. She presented with coma, acute respiratory failure, cardiac arrest and, after return of spontaneous circulation, severe circulatory shock. The patient did not respond favorably to conventional therapy with inotropes, vasopressors, glucagon or high dose insulin, so intravenous lipid emulsion was used. Hemodynamics improved following the first dose of 500mL of 20% Intralipid. Following the second dose of Intralipid, the patient was weaned to low-dose norepinephrine and her shock state resolved shortly thereafter. The patient later suffered brain death secondary to hypoxic-ischemic brain injury and was subsequently referred for organ donation.
CONCLUSION: Despite the unfortunate outcome of the case, we believe that intravenous lipid emulsion had a beneficial effect in the treatment of this patient with propranolol toxicity and cardiovascular collapse.
Author Block: J. Amayo1, K. Horton2, J. D. Butler3; 1Division of Pulmonary, Critical Care and Sleep Medicine, Piedmont Healthcare, Atlanta, GA, United States, 2Emergency Medicine Pharmacy Department, Piedmont Healthcare, Stockbridge, GA, United States, 3Piedmont Healthcare - Division of Pulmonary, Critical Care and Sleep Medicine, Atlanta, GA, United States.
BACKGROUND: Propranolol is a highly lipophilic, non-cardioselective beta blocker. There is a paucity of data for the use of IV lipid emulsion for propranolol toxicity. We describe a case of propranolol overdose associated with cardiovascular collapse and subsequent cardiopulmonary arrest which was treated with IV lipid emulsion.
CASE REPORT: A 28-year-old female ingested an unknown amount of propranolol in addition to ethanol, ibuprofen, aspirin and acetaminophen. She presented with coma, acute respiratory failure, cardiac arrest and, after return of spontaneous circulation, severe circulatory shock. The patient did not respond favorably to conventional therapy with inotropes, vasopressors, glucagon or high dose insulin, so intravenous lipid emulsion was used. Hemodynamics improved following the first dose of 500mL of 20% Intralipid. Following the second dose of Intralipid, the patient was weaned to low-dose norepinephrine and her shock state resolved shortly thereafter. The patient later suffered brain death secondary to hypoxic-ischemic brain injury and was subsequently referred for organ donation.
CONCLUSION: Despite the unfortunate outcome of the case, we believe that intravenous lipid emulsion had a beneficial effect in the treatment of this patient with propranolol toxicity and cardiovascular collapse.
|
Home
|
Inbox
|
Search
|