08 July 2024
: Case report 
Effective Management of Severe Amlodipine/Atenolol Overdose with Intravenous Calcium, Hyperinsulinemic Euglycemia Therapy, and Continuous Veno-Venous Hemodialysis: A Case Report
Unusual clinical course, Challenging differential diagnosis, Management of emergency care, Adverse events of drug therapy
Cong Tan Nguyen12ACEF, Van Cuong Bui12ABC, Ngoc Son Do12AF, Thi Huong Giang Bui
13AF, The Thach Pham12AF, Tuan Phong Hoang1ABCD, Duc Trieu Ho 12ACDEF*
DOI: 10.12659/AJCR.943777
Am J Case Rep 2024; 25:e943777
Table 2. The clinical course of the patient during treatment on day 1.
| At ICU admission | After 5 hours | After 10 hours | After 12 hours | After 14 hours | After 18 hours | After 21 hours | |
|---|---|---|---|---|---|---|---|
| ECG | Sinus bradycardia | Junctional bradycardia | Junctional bradycardia | Junctional bradycardia | Junctional bradycardia | Junctional bradycardia | Junctional bradycardia |
| BP (mmHg) | 75/45 | 90/55 | 100/65 | 130/75 | 125/70 | 110/65 | 110/60 |
| CVP (mmHg) | 20 | 18 | 15 | ||||
| UOP (mL) | 0 | 200 | |||||
| Lactate | 13.4 | >15 | 14.5 | 10.2 | 4.6 | 3.9 | |
| pH | 7.16 | 7.14 | 7.31 | 7.37 | 7.4 | 7.39 | |
| PaCO | 17 | 18 | 26 | 28 | 29 | 35 | |
| HCO | 6 | 6.1 | 13.1 | 16.2 | 18 | 22.1 | |
| PaO | 167 | 115 | 110 | 129 | 127 | 89 | |
| FiO (%) | 70 | 70 | 50 | 50 | 50 | 40 | |
| CVVHD | Start | Continue | Continue | Continue | Continue | Continue | Continue |
| Propofol | Start | Continue | Continue | Continue | Continue | Continue | Continue |
| Insulin | Start | Continue | Continue | Continue | Continue | Continue | |
| Calcium | Start | Continue | Continue | Continue | Continue | Continue | |
| Bicarbonate infusion | Start | Stop | |||||
| Epinephrine infusion | ↑ | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ |
| Norepinephrine infusion | ↑ | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ |
| Dobutamine infusion | ↑ | ↑ | ↑ | ↓ | ↓ | ↓ | ↓ |
| ECG – electrocardiogram; ICU – Intensive Care Unit; BP – blood pressure; CVP – central venous pressure; UOP – urine output; PaCO – arterial partial pressure of carbon dioxide; HCO, bicarbonate; PaO – arterial partial pressure of oxygen; FiO – fraction of inspired oxygen; CVVHD – continuous veno-venous hemodialysis; ↑ – increase infusion rate; ↓ – decrease infusion rate. | |||||||