Intravenous lipid emulsion therapy in calcium channel blocker and beta-blocker poisoning

Intravenous lipid emulsion (ILE) therapy is recommended for the treatment of poisoned patients with cardiovascular collapse secondary to lipophilic drug poisoning, e.g., beta blockers (BB) and calcium channel blockers (CCB).

We aimed to present our experiences with ILE therapy in CCB and BB poisoning.

Our emergency medicine clinic has a toxicology intensive care unit for patients who require hospitalization and follow-up because of unintentional or suicidal attempt intoxication. A total of five patients with intoxication were hospitalized in our toxicology intensive care unit sequentially between March 2014 and March 2015. Data for this case series were obtained by screening the patient files.

Our study comprises five case reports: three CCB and two BB poisoning. We gave ILE treatment to patients who were unresponsive to routine CCB and BB poisoning therapy. After ILE treatment, three of the five patients were discharged from hospital and the other two died. We observed that ILE therapy had positive effects on three of the patients’ hemodynamic parameters and vital signs. For two of the patients, however, the treatment did not have a positive impact on blood pressure and heart rate. After ILE treatment, only one patient had lipemia and pleural effusion as a secondary complication of therapy.

ILE therapy can be effective in the treatment of CCB and BB drug poisoning.