Acute respiratory distress syndrome following intralipid emulsion therapy

2.5 out of 5 stars Acute respiratory distress syndrome following verapamil overdose treated with intravenous lipid emulsion; A rare life-threatening complication. Martin C et al.  Ann Fr Anesth Reanim 2014 [Epub ahead of print] Reference This interesting French case report is a textbook example of how not to use intralipid emulsion therapy (ILE) in calcium-channel-block (CCB) overdose. It describes a 51-year-old woman who present to the emergency room 8 hours after ingesting forty 240 mg verapamil, a total of 9.6 grams. She was hypotensive and bradycardic, although alert and oriented. Initial echocardiography showed good systolic function. She was given fluids and calcium, and a temporary transvenous pacemaker placed. Six hours after presentation the patient was intubated after her oxygen saturation decreased and she required high-dose pressors. At that point, “A literature review suggested the use of lipid therapy as a possible antidote,” and an intralipid bolus was given followed by continuous infusion. After 4 hours of infusion, the patient developed signs of acute respiratory distress syndrome (ARDS). Echocardiography at this point showed impaired systolic function with an ejection fraction of 35%. Veno-arterial extracorporeal membrane oxygenation (ECMO) and continuous veno-venous hemofiltration (CVVH) was started, as well as plasmapharesis. The patient slowly recovered. She was extubated on day 9 and discharged from the ICU on day 18, with intact pulmonary...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical adverse drug reaction calcium channel blocker overdose intralipid emulsion therapy verapamil Source Type: news