Cardiac arrest due to a fatal dose of propranolol successfully treated with intravenous lipid infusion

• Published in: The Turkish Journal of Pediatrics
• Main Authors: Edin Botan, Tanıl Kendirli, Emrah Gün, Serdar Balsak, Mehmet Ramoğlu, Ercan Tutar
• Format: Article
• Language: English
• Published: Hacettepe University Institute of Child Health 2021-10-01
• Subjects: beta blockers; children; intravenous lipid infusion therapy; poisoning; propranolol
• Online Access: https://turkjpediatr.org/article/view/375
• ISSN: 0041-4301; 2791-6421

Background. Beta blockers (BB) are used for very different indications in both adults and children. There can be mild adverse effects with normal doses. When taken in toxic doses, this can have fatal results in children. There are some standard therapies during BB poisoning such as insulin and glucagon but there is not enough knowledge concerning intravenous lipid infusion therapy (ILI). Case. Herein we present a case of propranolol poisoning in a previously healthy 2-year-old girl. In this patient, cardiac arrest developed twice, and cardiopulmonary resuscitation was performed for 5 and 20 minutes, respectively. We initiated inotropes, insulin, calcium and glucagon with a lack of response to all medical treatment. We used ILI and the patient improved after this treatment. She recovered without any disability. Conclusions. ILI treatment should be considered with life-threatening BB poisoning which is unresponsive to standard therapies.