Successful single-pass albumin dialysis in the management of severe calcium channel blocker poisoning.

Abstract

Cardiac conduction disturbances, severe hypotension, cardiogenic shock, and pleural effusion, which lead to high disability and mortality rates, may occur as a result of calcium channel blocker (CCB) poisoning (1–3). In cases of toxicity with these drugs, which do not have specific antidotes, gastric lavage and active charcoal, and treatment with fluid load, high-dose calcium, insulin-glucose, glucagon, lipid emulsion and vasopressor-inotropic drugs may be used, if needed. Clearance of these drugs, which have a high degree of plasma protein binding, is not possible with classic hemodialysis (1, 2). In this article, we describe successful single-pass albumin dialysis (SPAD) in a pediatric patient who presented with severe verapamil intoxication that was unresponsive to classic treatments.