scholarly journals Calcium Channel Blocker-Associated Chyloperitoneum in Patients Receiving Peritoneal Dialysis: A Systematic Review

2019 ◽  
Vol 16 (8) ◽  
pp. 1333 ◽  
Author(s):  
Seungyeon Kim ◽  
Yun Mi Yu ◽  
Jeongyoon Kwon ◽  
Hyejin Yoo ◽  
Sun Hoi Jung ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cohort Studies ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Healthcare Professionals ◽  
Channel Blocker ◽  
Case Reports ◽  
Case Series ◽  
Risk Of Bias ◽  
Clinical Conditions

Unlike chyloperitoneum associated with clinical conditions including cancer, cirrhosis, and traumatic surgery, calcium channel blocker (CCB)-associated chyloperitoneum is rarely discussed in comprehensive studies on chyloperitoneum. We aimed to investigate the prevalence and characteristics of CCB-associated chyloperitoneum in peritoneal dialysis (PD) patients. The MEDLINE, Embase, CENTRAL, CiNii, and RISS databases were systematically searched for clinical studies on CCB-associated chyloperitoneum in PD patients published up to 31 July 2018. A total of 17 studies (four cohort studies, one case series, and 12 case reports) were selected. Eight CCBs, namely amlodipine, benidipine, diltiazem, lercanidipine, manidipine, nifedipine, nisoldipine, and verapamil, were reported to be associated with chyloperitoneum; manidipine and lercanidipine were the most frequently reported. The average prevalence of chyloperitoneum for lercanidipine was 25.97% in three cohort studies, two of which had a moderate or high risk of bias. Most of the studies revealed chyloperitoneum development within 4 days of initiation of CCB therapy and chyloperitoneum disappearance within 24 h of CCB withdrawal. The results of this study emphasise on the need for awareness among healthcare professionals regarding CCB-associated chyloperitoneum in PD patients. Further studies elucidating the causality and clinical implication of CCB-associated chyloperitoneum are needed.

scholarly journals Association between Prior Calcium Channel Blocker use and Mortality in Septic Patients: A Meta-Analysis of Cohort Studies

2020 ◽  
Author(s):  
Xianfei Ding ◽  
Yuqing Cui ◽  
Yanhui Zhu ◽  
Huoyan Liang ◽  
Dong Wang ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Studies ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Sensitivity Analyses ◽  
Sepsis Management ◽  
Term Survival

Abstract Background: To comprehensively review the literature and synthesize evidence concerning the relationship between preadmission calcium channel blocker (CCB) use and mortality in patients with sepsis.Methods: The MEDLINE, EMBASE, and Cochrane CENTRAL databases were searched from their inception to April 9, 2020. Cohort studies that related to prior CCB use in patients with sepsis were analysed. Pairs of reviewers independently screened studies, extracted data, and assessed the risk of bias. Two primary outcomes related to mortality, namely, 30-day mortality and 90-day mortality, were analysed; heterogeneity between studies was assessed using I2 and was considered moderate if I2 was equivalent to 50–75% and high if I2 ≥ 75%. Fixed and random-effects models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). The quality of outcomes was evaluated with the Newcastle-Ottawa Scale (NOS). Sensitivity analyses were performed to examine the robustness of the results.Results: 552 potentially relevant studies were identified, and the full texts of 25 articles were reviewed. Ultimately, five cohort studies involving 280,982 patients were confirmed to have a low risk of bias and were included. Preadmission CCB use was associated with a significantly lower 30-day mortality in septic shock (OR, 0.61 [0.38-0.97]; P = 0.035; I2 = 62.4%), not in sepsis (OR, 0.83 [0.66-1.04]; P = 0.103; I2 = 95.4%). Moreover, prior CCB use could significantly reduce 30-day mortality in sepsis (OR, 0.90 [0.85-0.95]; P < 0.001; I2 = 31.9%). Conclusions: This meta-analysis suggests that preadmission CCB use is significantly associated with improving long-term prognosis of sepsis, and also short-term survival of septic shock patients. This finding may provide an attractive direction for sepsis management.

scholarly journals Association Between Prior Calcium Channel Blocker Use and Mortality in Septic Patients: A Meta-Analysis of Cohort Studies

2021 ◽  
Vol 12 ◽  
Author(s):  
Xianfei Ding ◽  
Yuqing Cui ◽  
Huoyan Liang ◽  
Dong Wang ◽  
Lifeng Li ◽  
...  
Keyword(s):  
Septic Shock ◽  
Cohort Studies ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Secondary Outcome ◽  
Short Term ◽  
Short Term Mortality

Background: The aim of this study was to comprehensively review the literature and synthesize the evidence concerning the relationship between prior calcium channel blocker (CCB) use and mortality in patients with sepsis.Methods: The Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Cochrane CENTRAL, and Web of Science databases were searched from their inception to April 9, 2020. Cohort studies related to prior calcium channel blocker use in patients with sepsis were analyzed. Pairs of reviewers independently screened the studies, extracted the data, and assessed the risk of bias. The primary outcome of 90-days mortality or secondary outcome of short-term mortality, including 30-days, Intensive Care Unit (ICU), and in-hospital mortality, were analyzed. Heterogeneity among studies was assessed using the I2 statistic and was considered moderate if I2 was 50–75% and high if I2 was ≥75%. Random-effects models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). The quality of the studies was evaluated with the Newcastle-Ottawa Scale (NOS). Sensitivity analyses were performed to examine the robustness of the results.Results: In total, 639 potentially relevant studies were identified, and the full texts of 25 articles were reviewed. Ultimately, five cohort studies involving 280,982 patients were confirmed to have a low risk of bias and were included. Prior CCB use was associated with a significantly lower 90-days mortality in sepsis patients [OR, 0.90 (0.85–0.95); I2 = 31.9%]. Moreover, prior CCB use was associated with a significantly reduced short-term mortality rate in septic shock patients [OR, 0.61 (0.38–0.97); I2 = 62.4%] but not in sepsis patients [OR, 0.83 (0.66–1.04); I2 = 95.4%].Conclusion: This meta-analysis suggests that prior CCB use is significantly associated with improved 90-days mortality in sepsis patients and short-term mortality in septic shock patients. This study provides preliminary evidence of an association between prior CCB use and mortality in sepsis patients.

High-Dose Insulin Therapy for Calcium-Channel Blocker Overdose

2005 ◽  
Vol 39 (5) ◽  
pp. 923-930 ◽  
Author(s):  
Greene Shepherd ◽  
Wendy Klein-Schwartz
Keyword(s):  
Insulin Therapy ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Animal Studies ◽  
Channel Blocker ◽  
Case Reports ◽  
Data Extraction ◽  
Case Series ◽  
High Dose ◽  
Inotropic Effects

OBJECTIVE: To evaluate the evidence for using high-dose insulin therapy with supplemental dextrose and potassium in calcium-channel blocker (CCB) overdose. DATA SOURCES: Evidence of efficacy for high-dose insulin therapy with supplemental dextrose and potassium was sought by performing a search of MEDLINE and Toxline between 1966 and July 2004 using combinations of the terms calcium-channel blocker, overdose, poisoning, antidote, and insulin. Abstracts from the North American Congress of Clinical Toxicology for the years 1996–2003 were also reviewed. STUDY SELECTION AND DATA EXTRACTION: Identified articles, including animal studies, case reports, and case series, were evaluated for this review. No clinical trials were available. DATA SYNTHESIS: Animal models of CCB overdose demonstrate that high-dose insulin with supplemental dextrose and potassium was a more effective therapy than calcium, glucagon, or catecholamines. High-dose insulin appears to enhance cardiac carbohydrate metabolism and has direct inotropic effects. Published clinical experience is limited to 13 case reports where insulin was used after other therapies were failing; 12 of these patients survived. High-dose insulin therapy was beneficial for CCB-induced hypotension, hyperglycemia, and metabolic acidosis. Bradycardia and heart block resolved in some patients, but persisted in others. CONCLUSIONS: Based on animal data and limited human experience, as well as the inadequacies of available alternatives for patients with significant poisoning, high-dose insulin therapy warrants further study and judicious use in patients with life-threatening CCB poisoning.

Hemodynamic impact of molecular adsorbent recirculating system in refractory vasoplegic shock due to calcium channel blocker poisoning

2021 ◽  
pp. 039139882110078
Author(s):  
Christophe Beyls ◽  
Stéphanie Malaquin ◽  
Pierre Huette ◽  
Aurélien Mary ◽  
Patricia Besserve ◽  
...  
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Case Series ◽  
Hemodynamic Parameters ◽  
Median Length ◽  
Dynamic Changes ◽  
Molecular Adsorbent Recirculating System ◽  
Norepinephrine Dose ◽  
Molecular Adsorbent

Objective: To report the hemodynamic effect of to the molecular adsorbent recirculating system (MARS™) therapy for patients in refractory vasoplegic shock due to calcium channel blocker (CCB) poisoning Methods: We report a retrospective cohort of patients who were hospitalized for CCB poisoning with refractory vasoplegic shock and treated by MARS therapy, at Amiens Hospital University, from January 2010 to December 2019. Improvement in hemodynamic was assessed by dynamic changes in mean arterial pressure (MAP) and norepinephrine levels over a 24-h period after MARS therapy. Cardiac function was assessed by transthoracic echocardiography. Results: MARS therapy was performed on seven patients for CCB poisoning. CCB poisoning included nicardipine ( n = 3, 43%) amlodipine ( n = 3, 43%), and verapamil ( n = 1, 14%). The median time to start MARS therapy was 24 [14–27] h after drug ingestion and 6 [2–9] h after ICU admission. Cardiac output was preserved for all patients. MAP values improved from 56 [43–58] to 65 [61–78] 16 mmHg ( p = 0.005). Norepinephrine dose significantly decreased from 3.2 [0.8–10] µg/kg/min to 1.2 [0.1–1.9] µg/kg/min ( p = 0.008) and lactate level decreased from 3.2 [2.4–3.4] mmol/l−1 to 1.6 [0.9–2.2] mmol/l−1 ( p = 0.008). The median length of ICU stay was 4 (2–7) days and hospital stay was 4 (4–16) days. No complication related to the MARS therapy were reported. No patient died and all were discharged from the hospital. Conclusion: We reported the largest case-series of MARS therapy for refractory vasoplegic shock due to CCB poisoning. We observed that MARS therapy was associated with an improvement of hemodynamic parameters.

scholarly journals Calcium-Channel-Blocker-Influenced Gingival Enlargement: A Conundrum Demystified

Oral ◽  
2021 ◽  
Vol 1 (3) ◽  
pp. 236-249
Author(s):  
Pallavi Tonsekar ◽  
Vidya Tonsekar
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Case Reports ◽  
Treatment Options ◽  
Study Selection ◽  
Gingival Enlargement ◽  
Google Search

The aim of the article is to discuss the development of calcium channel blocker (CCB) influenced gingival enlargement. Data and Sources: MEDLINE/PubMed, Scopus, ScienceDirect, and Google Search databases. The article reviews contemporary and classic literature with a focus on pathophysiology, clinical presentation, and risk factors associated with this condition. The application of various treatment options is also discussed. Study selection: Clinical studies, systematic reviews, in vitro studies, and case reports. Conclusion: Dental plaque, genetic predisposition, and type of drug used are critical in the development of drug-influenced gingival enlargement (DIGE). The surgical technique employed to treat the pathosis plays an important role in long term success of therapy. There has been an upward trend in occurrence of CCB-influenced gingival enlargement due to the unbridled use of CCBs. Due to the cosmetic and functional ramifications; the review underscores the importance of clinical research on prevention, treatment, and causes of recurrence of CCB-influenced gingival enlargement.

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