Table 1 Timeline of the patient's clinical course through the administration of lipids
From: Lipid rescue of massive verapamil overdose: a case report
Time | Temp | Pulse | Rhythm | BP | Vent | Epi | Norepi | Vaso |
|---|---|---|---|---|---|---|---|---|
Admit (Day 1) | 36.7 | 59 | SB | 115/73 | 99% 2L NC | 0 | 0 | 0 |
+8 hrs | Â | 56 | Junctional | 85/50 | 91% 6L NC | 0 | 0 | 0 |
Abrupt clinical decline; intubation necessitated; bradycardia requiring transvenous pacer; vasopressors, furosemide, hydrocortisone, antibiotics, calcium, insulin and glucagon infusions begun | ||||||||
+24 hrs (Day 2) | 38.5 | 100 | Paced | 97/60 | SIMV FiO2 80% | 0.02 | 0.3 | 0.04 |
Hypercoagulable requiring heparin infusion; bicarbonate infusion for acidosis; oliguric with renal failure requiring continuous venovenous hemodialysis (CVVH) | ||||||||
+48 hrs (Day 3) | 38.2 | 70 | Paced | 90/49 | SIMV FiO2 85% | 0 | 0.418 | 0.05 |
Worsening respiratory status requiring airway pressure release ventilation (APRV); anuric and pacer dependent | ||||||||
+72 hrs (Day 4) | 38.4 | 70 | Paced | 124/72 | APRV FiO2 80% | 0.04 | 0.75 | 0.05 |
Intravenous lipid infusion started | ||||||||
+76 hrs | 37.5 | 70 | Paced | 149/63 | APRV FiO2 90% | 0.04 | 0.75 | 0.05 |
+80 hrs | 37.2 | 70 | Paced | 128/72 | APRV FiO2 50% | 0.04 | 0.3 | 0.04 |
+96 hrs (Day 5) | 36.8 | 70 | Paced | 134/88 | APRV FiO2 50% | 0.03 | 0.1 | 0.04 |
+120 hrs (Day 6) | 37.2 | 70 | Paced | 106/58 | APRV FiO2 50% | 0.01 | 0.05 | 0 |
Improving respiratory status; APRV, CVVH, lipids, HIE, calcium, bicarbonate, and pacing stopped | ||||||||
+144 hrs (Day 7) | 37.6 | 67 | Junctional | 101/54 | Vol A/C FiO2 65% | 0 | 0.03 | 0 |