Hemoadsorption Therapy for Calcium Channel Blocker Overdose at a Tertiary-level Intensive Care Unit: A Retrospective...

Area of Science:

• Toxicology
• Critical Care Medicine
• Cardiovascular Pharmacology

Background:

• Calcium channel blocker (CCB) overdose presents a significant challenge in intensive care units (ICUs).
• Management of CCB overdose often requires aggressive interventions to support hemodynamics.
• Identifying effective therapies for refractory CCB overdose is crucial.

Purpose of the Study:

• To determine the incidence and characteristics of CCB overdose admissions in a tertiary ICU.
• To evaluate the management strategies and patient outcomes associated with CCB overdose.
• To assess the role of hemoadsorption therapy (HA) in CCB overdose.

Main Methods:

• Retrospective analysis of adult patients admitted to the ICU with confirmed CCB overdose between 2020 and 2022.
• Data collected included admission frequency, interventions (mechanical ventilation, vasopressors, high-dose insulin euglycemic therapy, calcium, methylene blue, fluid therapy, hemoadsorption), and patient outcomes.
• Comparison of outcomes between patients treated with hemoadsorption therapy (HA) and standard of care (SoC).

Main Results:

• CCB overdose accounted for 1.4% of ICU admissions, with a case fatality rate of 12.5%.
• Common interventions included vasopressors (92%) and mechanical ventilation (71%).
• Hemoadsorption therapy was associated with improved MAP increase at 48 hours and a trend towards lower mortality compared to SoC, despite higher initial illness severity.

Conclusions:

• CCB overdose is a life-threatening condition requiring intensive care.
• Modern resin hemoadsorption may offer a rescue therapy for refractory shock in CCB overdose.
• Further well-designed studies are needed to confirm the efficacy of HA in improving drug clearance and clinical outcomes.