How is hypotension treated in calcium channel blocker (CCB) toxicity?

Updated: Jan 04, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Blood pressure can be augmented with isotonic sodium chloride solution or Ringer lactate solution. Both are efficient volume expanders. Deliver fluid in 20-mL/kg boluses in children or 1-L boluses in adults. These may be repeated once, twice, or even three times if the patient remains hypotensive. Bedside ultrasound assessment of inferior vena cava size may guide adequate volume replacement. If blood pressure normalizes with fluid challenges, infuse IV fluid at 1-2 times the normal maintenance rate.

However, vasopressors are frequently necessary for adequate resuscitation and should be started early if hypotension occurs. [25]

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