Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose.

Jose M Cardenas, Santiago Borasino, Joseph Timpa, Jeremy Hawkins, Martha McBride, William Rushton, Jordan Newman, Erika Mendoza, Robert Sorabella, Jonathan Byrnes

The journal of extra-corporeal technology 2023 Dec

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Calcium channel blocker (CCB) toxicity carries a high mortality and is the sixth most fatal drug class reported to US poison centers. Amlodipine overdose is characterized by a life-threatening arterial vasodilation that compromises organ perfusion. The management of CCB intoxication is focused on maintaining adequate organ perfusion. In cases refractory to medical therapies, hemodynamic support with extracorporeal membrane oxygenation (ECMO) is warranted necessitating higher flows than usual to compensate for the vasodilation and requiring central cannulation. We present a case of a 12-year-old with severe dihydropyridine CCB ingestion, refractory to medical management and successfully treated with central ECMO cannulation. The patient was discharged home with no significant disability. Central ECMO cannulation may be helpful to facilitate adequate flows in vasodilatory shock such as CCB overdose. © The Author(s), published by EDP Sciences, 2023.

Citation

Jose M Cardenas, Santiago Borasino, Joseph Timpa, Jeremy Hawkins, Martha McBride, William Rushton, Jordan Newman, Erika Mendoza, Robert Sorabella, Jonathan Byrnes. Central ECMO cannulation for severe dihydropyridine calcium channel blocker overdose. The journal of extra-corporeal technology. 2023 Dec;55(4):206-208