title: Intravenous lipid emulsion therapy for sustained release diltiazem poisoning: a case report.
abstract: We present a case of refractory cardiogenic shock secondary to sustained release diltiazem poisoning.  Intravenous lipid emulsion therapy was initiated approximately 13 hours after ingestion. Vasopressors were weaned off hours after initiation of intravenous lipid emulsion therapy and the patient went on to make a full recovery.  This report adds to the paucity of data on intravenous lipid emulsion rescue therapy in sustained release diltiazem poisoning. We hypothesize that the intravenous lipid emulsion may have mediated its favorable hemodynamic effects via increases in myocardial calcium concentration with resultant increased inotropy.
authors: Department of Medicine, University of Calgary, Calgary, Alberta. ben.wilson@albertahealthservices.ca
authors: Ben J
authors: BJ
authors: Wilson
authors: Jack S
authors: JS
authors: Cruikshank
authors: Kim L
authors: KL
authors: Wiebe
authors: Valerian C
authors: VC
authors: Dias
authors: Mark C
authors: MC
authors: Yarema
mesh_terms: D002118:Calcium / Q000378:metabolism; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000506:poisoning*; D003692:Delayed-Action Preparations; D004110:Diltiazem / Q000008:administration & dosage / Q000506:poisoning*; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D012770:Shock, Cardiogenic / Q000139:chemically induced / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D003692:Delayed-Action Preparations; D005217:Fat Emulsions, Intravenous; D004110:Diltiazem; D002118:Calcium