• Banu Katlan, Selman Kesici, and Benan Bayrakci.
• From the Departmant of Intensive Care Medicine, Life Support Center, Hacettepe University Ihsan Doğramaci Children's Hospital, Ankara, Turkey.
• Pediatr Emerg Care. 2023 Mar 1; 39 (3): 120124120-124.

BackgroundCalcium-channel blocker (CCBs) intoxication remains the most lethal among all other drug overdoses (Arroyo and Kao. Pediatr Emerg Care 2009;25:533-538). This study aimed to describe the use and efficacy of intravenous lipid emulsion treatment in our CCB overdose patients in tandem with a comprehensive literature investigation.Case ReportsHereby we report 4 adolescent patients who arrived to the pediatric emergency department after intentional CCB ingestions. All patients were hospitalized in pediatric intensive care unit because of hypotension, and they were initially treated with fluid boluses, glucagon, calcium infusion, vasopressors, inotropes and insulin. Intravenous lipid emulsion (dose: 20% lipid emulsion given as a 1.5-mL/kg bolus followed by 0.25-0.5 mL/kg/min for 30-60 minutes) treatment was given to all patients unresponsive to initial treatments. Hemodynamic instability improved immediately after intravenous lipid emulsion treatment. All patients were discharged with complete recovery at the sixth day of pediatric intensive care unit admission.ConclusionsIntravenous lipid emulsion therapy stands as a salvage treatment for CCB intoxications with cardiovascular failure unresponsive to standard supportive treatments.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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