ArticleClinical practice and cases in emergency medicine2025
Interfacility Transfer for VA-ECMO in Beta Blocker and Calcium Channel Blocker Overdoses: A Report of Two Cases.
Article in Clinical practice and cases in emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of treatments for propranolol toxicity: a systematic review of current approaches and evidence.European journal of clinical pharmacology · 2026Pooled it
- Article
- Successful VA-ECMO rescue of life-threatening cardiotoxicity following paclitaxel and cisplatin neoadjuvant chemotherapy for laryngeal cancer: a case report.BMC cardiovascular disorders · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCalcium channel blocker (CCB) and beta blocker (BB) overdoses are life-threatening conditions that can lead to vasoplegic and cardiogenic shock. Treatment involves a combination of vasopressors, calcium, glucagon, and/or high-dose insulin euglycemia therapy. The most severe overdoses may require venoarterial extracorporeal membrane oxygenation (VA-ECMO), which often results in interfacility transfers. This report describes two successful VA-ECMO transfers for refractory CCB/BB overdose. CASE REPORTS: CASE 1: A 56-year-old male developed severe hypotension after ingesting 40-45 tablets of 10 milligram (mg) amlodipine tablets. After initial treatment approaches were unsuccessful, an early interdisciplinary discussion facilitated timely cannulation at the initial facility and quick transfer for VA-ECMO initiation. The patient was discharged at his neurological baseline after 60 days. CASE 2: A 19-year-old female presented to the emergency department after a polypharmacy ingestion including 60 tablets of 20 mg propranolol. An early interdisciplinary discussion between the medical intensive care unit, medical toxicology, and the ECMO team allowed for prompt transfer directly to the receiving hospital catheterization lab for VA-ECMO within three hours of the initial presentation. The patient was discharged to an inpatient psychiatric facility after nine days.
conclusionVenoarterial extracorporeal membrane oxygenation for refractory shock due to CCB and BB overdoses can be a life-saving intervention. Interfacility transfer of poisoned patients for VA-ECMO is logistically challenging, which can delay the appropriate care for patients with an otherwise morbid prognosis. A streamlined interfacility transfer protocol with multidisciplinary collaboration can help optimize outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.