Journal of Clinical Toxicology

Journal of Clinical Toxicology
Open Access

ISSN: 2161-0495

+44 1478 350008

Jan T Kielstein

Medical Clinic V, Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital Braunschweig, Salzdahlumer Straße 90, 38126 Braunschweig, Germany

  • Case Report   
    Life-Threatening Amlodipine Over Dose Requiring ECMO Support Treated by High-Cut-Off Dialysis and Cytosorb
    Author(s): Julius J Schmidt*, Markus Busch, Sascha David, W. Nikolaus Kuhn Velten, Marius M Hoeper and Jan T Kielstein

    Calcium Channel Blockers (CCBs) may cause profound vasopressor resistant hypotension in case of intoxication. Recently, the EXTRIP workgroup recommended against the use of Extra Corporeal Treatment Modalities (ECTM) for the elimination of amlodipine. Anecdotal evidence suggests that Veno-Arterial Extra Corporeal Membrane Oxygenation (VA-ECMO) may be beneficial in patients with severe shock due to amlodipine intoxication. We report a case of severe amlodipine poisoning (total amlodipine intake 625 mg), in which we used awake-VA- ECMO support for hemodynamic stabilization. A combination of a HCO dialyzer and the Cytosorb® adsorber was used to eliminate amlodipine in two consecutive treatment sessions. Amlodipine dialyzer clearance and Cytosorb® adsorber clearance were 13.8 (-2,3–20.4) mL/min and 17.5 (9.6–25.6) mL/min, res.. View More»
    DOI: 10.35248/2161-0495.21.11.479

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