Successful treatment of metoprolol-induced cardiac arrest with high-dose insulin, lipid emulsion and extracorporeal membrane oxygenation

Beta-adrenergic antagonist toxicity causes cardiovascular collapse often refractory to standard therapy. Alternative therapies include high-dose insulin, lipid emulsion and venoarterial extracorporeal membrane oxygenation (VA-ECMO).CaseA 47-year-old male ingested ten grams of metoprolol tartrate in a suicide attempt. Upon emergency department (ED) presentation, he was comatose, bradycardic and hypotensive. Glucagon (14mg IV) and vasopressor/inotropic support (epinephrine 0.1 mcg/kg/min, dobutamine 10 mcg/kg/min) were administered.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Case Report Source Type: research