Article

Whole bowel irrigation and the hemodynamically unstable calcium channel blocker overdose: primum non nocere.

The Toxikon Consortium at Cook County Hospital, Chicago, Illinois 60612, USA.
Journal of Emergency Medicine (impact factor: 1.31). 08/2008; 38(2):171-4. DOI:10.1016/j.jemermed.2007.11.100
Source: PubMed

ABSTRACT Sustained-release calcium channel blocker (CCB SR) overdoses are potentially life-threatening ingestions. These patients may not become hemodynamically unstable until many hours after ingestion. On theoretical grounds, some have suggested that whole bowel irrigation (WBI) with polyethylene glycol electrolyte lavage solution may be of value in the management of these cases. We report two cases with poor outcome (including one fatality) that were complicated by the use of WBI. Both cases were treated with WBI beginning before and continuing after developing hypotension. WBI should be avoided in the setting of the hemodynamically unstable CCB SR overdose.

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Keywords

fatality
 
hemodynamically unstable CCB SR overdose
 
polyethylene glycol electrolyte lavage solution
 
poor outcome
 
Sustained-release calcium channel blocker
 
WBI
 
whole bowel irrigation
 

Kirk L Cumpston