TY - JOUR
T1 - Extracorporeal cardiopulmonary resuscitation for the treatment of amlodipine overdose in a pediatric patient
AU - Giuliano, Katherine
AU - Chen, Y. Julia
AU - Coletti, Kristen
AU - O'Brien, Caitlin
AU - Jelin, Eric
AU - Garcia, Alejandro
N1 - Publisher Copyright:
© 2021 Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved.
PY - 2021/2/1
Y1 - 2021/2/1
N2 - We present the case of a 16-year-old female with systemic lupus erythematosus who presented with shock of unclear etiology, refractory to fluid resuscitation and triple vasopressors. She suffered pulseless electrical activity and underwent cannulation onto veno-arterial extracorporeal membrane oxygenation (ECMO). After cannulation, it was discovered she had intentionally overdosed on her home medication, amlodipine, a calcium channel blocker (CCB). She was supported on ECMO, treated with IV calcium and insulin, and was able to be weaned off ECMO after 4 days. She developed oligoanuric acute kidney injury, treated with continuous renal replacement therapy followed by intermittent hemodialysis. At discharge, she was neurologically intact and did not require dialysis. Herein, we review the treatment of CCB overdose, review the literature on the use of ECMO in refractory shock due to cardiovascular medication overdose, and highlight the utility of ECMO in pediatric refractory shock and/or cardiac arrest of unclear etiology.
AB - We present the case of a 16-year-old female with systemic lupus erythematosus who presented with shock of unclear etiology, refractory to fluid resuscitation and triple vasopressors. She suffered pulseless electrical activity and underwent cannulation onto veno-arterial extracorporeal membrane oxygenation (ECMO). After cannulation, it was discovered she had intentionally overdosed on her home medication, amlodipine, a calcium channel blocker (CCB). She was supported on ECMO, treated with IV calcium and insulin, and was able to be weaned off ECMO after 4 days. She developed oligoanuric acute kidney injury, treated with continuous renal replacement therapy followed by intermittent hemodialysis. At discharge, she was neurologically intact and did not require dialysis. Herein, we review the treatment of CCB overdose, review the literature on the use of ECMO in refractory shock due to cardiovascular medication overdose, and highlight the utility of ECMO in pediatric refractory shock and/or cardiac arrest of unclear etiology.
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U2 - 10.1093/jscr/rjab014
DO - 10.1093/jscr/rjab014
M3 - Article
C2 - 33628421
AN - SCOPUS:85104706642
SN - 2042-8812
VL - 2021
JO - Journal of Surgical Case Reports
JF - Journal of Surgical Case Reports
IS - 2
M1 - rjab014
ER -