Calcium channel blockers are commonly used in a variety of cardiovascular diseases. Their extensive clinical use concurs with an increase in the incidence of deliberate and accidental poisonings. Intoxication with non-dihydropyridine calcium channel blockers is currently treated with supportive therapies, since no antidote is available. When conventional therapies fail to achieve haemodynamic stability, alternative approaches should be considered.
In this case report we describe the effect of continuous renal replacement therapy and intravenous lipid emulsion in the treatment of severe verapamil intoxication. High-volume continuous venovenous haemofiltration did not have a substantial effect on verapamil clearance. However, after intravenous administration of lipid emulsion the haemodynamics stabilised, which suggests that this intervention is beneficial after life-threatening verapamil intoxication, although the exact underlying mechanism remains to be elucidated.
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