Terlipressin in refractory shock induced by diltiazem poisoning.
Poisoning caused by calcium-channels blockers (CCB) can cause refractory vasoplegic shock, resulting in multiple-organ failure and death despite maximal therapy including high doses of vasopressors. We report one CCB-induced refractory shock complicated with lactate acidosis despite very high doses of epinephrine and norepinephrine. The hemodynamic status of the patient dramatically improved after intermittent boluses of terlipressin, which corrected the acidosis.
Service de Réanimation Médicale, CHU Bordeaux, Bordeaux, France.
Claire
C
Ragot
Service des Soins Intensifs de Cardiologie, CHU Bordeaux, Bordeaux, France.
Edouard
E
Gerbaud
Service de Réanimation Médicale, CHU Bordeaux, Bordeaux, France. Electronic address: alexandre.boyer@chu-bordeaux.fr.
Alexandre
A
Boyer
D002121:Calcium Channel Blockers / Q000506:poisoning*; D003422:Critical Care; D004110:Diltiazem / Q000506:poisoning* / Q000627:therapeutic use; D062787:Drug Overdose / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008236:Lypressin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000139:chemically induced* / Q000188:drug therapy; D000077585:Terlipressin; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D014662:Vasoconstrictor Agents; D008236:Lypressin; D000077585:Terlipressin; D004110:Diltiazem
Calcium-channel blockers; Intoxication; Non-dihydropyridine; Terlipressin