Severe poisoning with sotalol and verapamil. Recovery after 4 h of normothermic CPR followed by extra corporeal heart lung assist.
In acute poisoning with beta-blocking drugs and calcium-channel blockers patients may present with serious symptoms. We present a case of life-threatening sotalol and verapamil intoxication in a 29-year-old female suffering from depression. She was admitted to our hospital a few hours after she had taken 3.6 g verapamil and 4.8 g sotalol. On being found the patient was breathing and had a palpable pulse. On admission the patient experienced a cardiovascular collapse and CPR was started. Echocardiography confirmed cardiac standstill. After 4 h of normothermic CPR, extra corporeal heart lung assist (ECHLA) was established. Vasoactive drugs could be stopped after 2 days with ECHLA, and after 5 days the patient was extubated. The patient experienced several complications (intestinal bleeding, transient nerve paralysis, and renal failure due to rhabdomyolysis) but made a complete recovery and started working 6 months after the poisoning. She was no longer depressed.
Rygnestad
T
T
St. Olavs. Hospital, Trondheim University Hospital, Trondheim, Norway. tarjei.rygnestad@ntnu.no
Moen
S
S
Wahba
A
A
Lien
S
S
Ingul
C B
CB
Schrader
H
H
Knapstad
S E
SE
D000319:Adrenergic beta-Antagonists / Q000506:poisoning*; D000328:Adult; D002121:Calcium Channel Blockers / Q000506:poisoning*; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced / Q000628:therapy; D006353:Heart-Assist Devices; D006801:Humans; D012121:Respiration, Artificial; D013015:Sotalol / Q000506:poisoning*; D013406:Suicide, Attempted; D014700:Verapamil / Q000506:poisoning*
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D013015:Sotalol; D014700:Verapamil