Acute Respiratory Distress Syndrome Associated with Intravenous Lipid Emulsion Therapy for Verapamil Toxicity, Successfully Treated with Veno-Venous ECMO

Friedman, Tom; Feld, Yair; Adler, Zvi; Bolotin, Gil; Bentur, Yedidia

doi:10.4172/2329-6631.1000182

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…There are reports implicating ARDS as a potential adverse event associated with ILE infusions in people, however most of the patients were critically ill, making it hard to discern whether ARDS resulted from ILE infusion or was a result of underlying illness (12, 27, 30). The authors do not believe that this patient had an additional condition predisposing to the development of ARDS, though this cannot be entirely ruled out.…”

Section: Discussionmentioning

confidence: 99%

“…Reported adverse events associated with ILE infusions are sporadic or extrapolated from its use in parenteral nutrition, there is a case report of suspected acute respiratory distress syndrome (ARDS) secondary to the use of ILE for verapamil toxicosis (12). The adverse events reported with ILE infusions include phlebitis, immunosuppression, cardiovascular, lipid-emboli, hemolysis, acute kidney injury, metabolic acidosis, pulmonary complications (acute lung injury, ARDS, hypoxia and ventilation-perfusion mismatch), pancreatitis or fat overload syndrome, hypersensitivity or allergic reactions and vomiting, persistent gross lipemia and suspected corneal lipidosis (2, 7, 9–11, 13–19).…”

Section: Introductionmentioning

confidence: 99%

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Suspected Acute Respiratory Distress Syndrome Associated With the Use of Intravenous Lipid Emulsion Therapy in a Dog: A Case Report

Botha

Jennings²,

Press

et al. 2019

Front. Vet. Sci.

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A 12-year-old male neutered Bichon Frise presented to the Emergency Department for stupor and bradycardia after ingestion of chocolate covered 450 mg (90 mg/kg) tetrahydrocannabinol. The patient was hospitalized for supportive care, IV fluid therapy and monitoring in the intensive care unit. During hospitalization the patient became comatose and bradypneic. Treatment with intravenous lipid emulsion (ILE) therapy was instituted to accelerate toxin elimination, reduce the risk of complications related to progressive obtundation and shorten hospitalization time. Five hours after infusion, the patient developed severe respiratory distress and was ultimately euthanized. Post-mortem histologic evaluation of lung revealed severe pulmonary edema consistent with acute respiratory distress syndrome. There are infrequent reports of adverse effects associated with ILE therapy for toxicosis in veterinary medicine despite reports of complications such as acute respiratory distress syndrome in human literature. The purpose of this report is to describe the potential for a severe adverse event after treatment of a toxicosis with ILE therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Suspected Acute Respiratory Distress Syndrome Associated With the Use of Intravenous Lipid Emulsion Therapy in a Dog: A Case Report

Botha

Jennings²,

Press

et al. 2019

Front. Vet. Sci.

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“…Показано, что передозировка верапамила сопровождается гипотензией, брадиаритмией, блоками атриовентрикулярной проводимости и остановкой сердца [10,11].…”

Section: обсуждение полученных результатовunclassified

Influence of l-type slow calcium channels blockers on cardiac, respiratory and motor activity at the intact and poisoned by physostigmine (eserine) of rats during the early ontogeny

Кузнецов

Владимирович²,

Kuznetsova

et al. 2019

Rev Clin Pharm Drug Ther

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The effects of calcium-channel blockers (CCBs) (verapamil, nifedipine) on heart rate, respiration rate and motor activity were studied in 3-30-day-old rats. The role of calcium channels in development of disturbances of a heart and respiratory rhythms after introduction to newborn rats of acetylcholinesterase (AChE) inhibitor of physostigmine was revealed. Parameters of functional activity of heart, respiratory and somatomotor systems in case of blockade of calcium channels were studied also under conditions of the activation of cholinoceptive structures caused by an injection to infant rats of AChE inhibitor after premedication by CCBs. It is shown that use of calcium channels blockers leads to development of bradycardia, and verapamil causes more expressed disturbance of a heart rhythm in rats of younger age, while blockade of dihydropyridinic receptors by nifedipine has no ontogenetic specifics. Similar ontogenetic dynamics concerns also reaction of respiratory system. Verapamil have a detrimental effect on respiration, up to a stop, in 3-7-day-old and to a lesser extent in 16-30-day-old infant rats. Nifedipine slightly reduces a respiration rate at younger infant rats, but raises it at the mature rats. The nifedipine injection more in comparison with verapamil changes the level and a pattern of motor activity. Preliminary blockade of calcium channels does not render significant change of reaction at the subsequent introduction of physostigmin.

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Mykotoxinvergiftung nach Walnussaufnahme bei 54 Hunden

Braun,

Kanstinger,

Dahlem

2024

Tierarztl Prax Ausg K Kleintiere Heimtiere

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Zusammenfassung Gegenstand und Ziel Ziel dieser retrospektiven Studie ist die Beschreibung der Intoxikation mit tremorgenen Mykotoxinen nach Walnussaufnahme bei einer großen Hundepopulation und die Evaluierung der Entwicklung der klinischen Symptomatik unter der initiierten Therapie. Material und Methoden Vierundfünfzig Hunde wurden in die Studie eingeschlossen, die vornehmlich mit Tremor, Hyperästhesie, Hyperthermie und Ataxie innerhalb weniger Stunden nach beobachteter oraler Aufnahme von Walnüssen oder begründetem Verdacht vorstellig wurden. Ergebnisse Vornehmlich wurden die Patienten im Winter und Frühling vorstellig. Dreiundfünfzig der 54 Hunde wurden zur symptomatischen sowie dekontaminierenden und eliminierenden Therapie stationär aufgenommen (98%). Zur symptomatischen Therapie kamen bei 14 Hunden eine antikonvulsive Therapie (26%) sowie bei der Hälfte der Patienten eine antiemetische Therapie (n=27; 50%) zum Einsatz. Eine forcierte Emesis zur Dekontamination wurde aufgrund des Schweregrads der neurologischen Symptome lediglich bei 6 Patienten eingeleitet (11%). Als weitere dekontaminierende Maßnahme erfolgte eine orale Gabe von Aktivkohle nach Besserung der klinischen Symptome (n=39; 72%). Die Mehrzahl der Hunde (n=45; 83%) erhielt eine intravenöse Lipidtherapie zur Elimination sowie isotone kristalloide Infusionslösung zum Ausgleich von Flüssigkeitsverlusten. Nebenwirkungen nach intravenöser Lipidtherapie wurden nicht beobachtet. Der Großteil der Patienten verblieb 2 Tage stationär (n=44; 81%). Bei der Mehrzahl der Patienten war die klinische Untersuchung am Tag der Entlassung unauffällig (n=39; 72%). Potenzielle Folgeschäden nach Mykotoxinvergiftung wurden bei keinem der Patienten im weiteren Verlauf dokumentiert. Schlussfolgerung Aufgrund der Lipophilie von Mykotoxinen kann der Einsatz einer intravenösen Lipidtherapie zur Toxinelimination in Erwägung gezogen werden. Die Prognose bei Mykotoxinvergiftung nach Walnussaufnahme nach dekontaminierenden und eliminierenden Maßnahmen ist gut. Klinische Relevanz Bei unspezifischen neurologischen Symptomen wie Tremor, Ataxie und Hyperästhesie sowie entsprechendem Vorbericht sollte eine Intoxikation mit Mykotoxin behafteten Walnüssen in Betracht gezogen werden.

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Acute Respiratory Distress Syndrome Associated with Intravenous Lipid Emulsion Therapy for Verapamil Toxicity, Successfully Treated with Veno-Venous ECMO

Cited by 3 publications

References 14 publications

Suspected Acute Respiratory Distress Syndrome Associated With the Use of Intravenous Lipid Emulsion Therapy in a Dog: A Case Report

Suspected Acute Respiratory Distress Syndrome Associated With the Use of Intravenous Lipid Emulsion Therapy in a Dog: A Case Report

Influence of l-type slow calcium channels blockers on cardiac, respiratory and motor activity at the intact and poisoned by physostigmine (eserine) of rats during the early ontogeny

Mykotoxinvergiftung nach Walnussaufnahme bei 54 Hunden

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