We report the successful application of single pass albumin dialysis (SPAD) and hemoadsorption (HA) in two teenagers with amlodipine poisoning. A 16-year-old girl with amlodipine overdose developed refractory shock and lactic acidosis despite multiple inotropes, calcium, insulin, and glucagon infusion. SPAD was initiated 18 h after the incident for 21 h. She improved dramatically and was able to wean off all inotropes 54 h after admission. Another 16-year-old girl required extracorporeal membrane oxygenation (ECMO) support after deliberate consumption of 1100-mg amlodipine. SPAD was initiated 13 h after the incident for 38 h, followed by two more sessions of HA using the Cytosorb column. All inotropes were stopped 18 h after terminating the HA, and ECMO was weaned off 28 h later. There were no major complications during the therapy. Our cases demonstrated that early extracorporeal removal can be considered as an adjunctive therapy in children with life-threatening amlodipine overdose.
Keywords: amlodipine; calcium channel blocker poisoning; extracorporeal treatment; hemoadsorption; single pass albumin dialysis.
© 2024 Wiley Periodicals LLC.