Journal of Intensive Care Medicine

 

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Journal of Intensive Care Medicine, Vol. 22, No. 6, 381-385 (2007)
DOI: 10.1177/0885066607307528

Extracorporeal Life Support in Severe Propranolol and Verapamil Intoxication

Jacek Kolcz, MD, PhD

Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Jagiellonian University, Kraków, Poland

Jacek Pietrzyk, MD,PhD

Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Jagiellonian University, Kraków, Poland

Katarzyna Januszewska, MD, PhD

Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Jagiellonian University, Kraków, Poland

Malgorzata Procelewska, MD

Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Jagiellonian University, Kraków, Poland

Tomasz Mroczek, MD

Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Jagiellonian University, Kraków, Poland

Edward Malec, MD, PhD

Department of Pediatric Cardiac Surgery, Polish-American Children's Hospital, Jagiellonian University, Kraków, Poland, mimalec{at}cyf-kr.edu.pl

Combined poisoning with calcium-channel blockers and ß-blockers is usually associated with severe heart failure. This report shows the effectiveness of emergency extracorporeal life support in treating life-threatening simultaneous propranolol and verapamil intoxication. A 15-year-old girl presented in cardiogenic shock after alcohol consumption and a propranolol and verapamil overdose; plasma concentrations: propranolol, 0.53 m/mL; verapamil, 1.06 mg/mL. She was successfully resuscitated with extracorporeal life support. Therapeutic plasma exchange was initiated. Extracorporeal support was discontinued 70 hours later. The patient made a full recovery. Simultaneous verapamil and propranolol overdoses can cause severe hemodynamic compromise and arrest of electrical and mechanical function of the heart. Emergency extracorporeal life support can successfully maintain vital organ blood flow and allows time for drug metabolism, redistribution, and removal. Therapeutic plasma exchange may reduce the time of emergency extracorporeal life support. Emergency extracorporeal life support should be considered early in cases of near-fatal intoxications with cardiodepressive drugs.

Key Words: propranolol/verapamil intoxication • cardiopulmonary resuscitation • extracorporeal life support

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This Article
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Right arrow Articles by Kolcz, J.
Right arrow Articles by Malec, E.
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