tailieunhanh - Báo cáo y học: "Hyperinsulinemia-euglycemia therapy: a useful tool in treating calcium channel blocker poisoning"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Hyperinsulinemia-euglycemia therapy: a useful tool in treating calcium channel blocker poisoning. | Available online http content 10 4 149 Commentary Hyperinsulinemia-euglycemia therapy a useful tool in treating calcium channel blocker poisoning Michael D Levine1 and Edward Boyer2 1 Department of Emergency Medicine Brigham and Women s Hospital Boston Massachusetts USA 2Division of Medical Toxicology Department of Emergency Medicine University of Massachusetts Medical School Worcester Massachusetts USA Corresponding author Edward Boyer Published 17 July 2006 Critical Care 2006 10 149 doi cc4964 This article is online at http content 10 4 149 2006 BioMed Central Ltd See related review by Lheureux et al. http content 10 3 212 Abstract Hyperinsulinemia-euglycemia HIE therapy when initiated promptly and aggressively may offer considerable advantages in the treatment of calcium channel blocker poisoning. Although its mechanism of action is uncertain HIE improves the efficiency with which the poisoned myocardium uses metabolic fuel the end result of which is improvements in inotropy and other cardiovascular parameters. Although HIE is not universally accepted the reports included in the previous issue of Critical Care should prompt clinicians to consider HIE an appropriate therapy specifically for calcium channel blocker poisoning. Interest in a bizarre treatment for calcium channel blocker poisoning namely hyperinsulinemia-euglycemia HIE continues to grow. In the previous issue of Critical Care Lheureux and coworkers 1 review this unusual therapy that was first proposed by medical toxicologists approximately 1 decade ago 2-4 . Clinicians unfamiliar with this treatment modality have been apprehensive about starting patients on HIE with good reason. A considerable amount of clinical advice on the management of intoxicated patients is delivered via poison control centers to administer enormous doses of insulin to a hypotensive bradycardic hyperglycemic acidotic patient based on the telephone .