The Use of Single Pass Albumin Dialysis and Hemoadsorption in Management of Life‐Threatening Amlodipine Overdose

We report the successful application of single pass albumin dialysis (SPAD) and hemoadsorption (HA) in two teenagers with amlodipine poisoning. A 16-year-old girl with amlodipine overdose developed refractory shock and lactic acidosis despite multiple inotropes, calcium, insulin, and glucagon infusion. SPAD was initiated 18 h after the incident for 21 h. She improved dramatically and was able to wean off all inotropes 54 h after admission. Another 16-year-old girl required extracorporeal membrane oxygenation (ECMO) support after deliberate consumption of 1100-mg amlodipine. SPAD was initiated 13 h after the incident for 38 h, followed by two more sessions of HA using the Cytosorb column. All inotropes were stopped 18 h after terminating the HA, and ECMO was weaned off 28 h later. There were no major complications during the therapy. Our cases demonstrated that early extracorporeal removal can be considered as an adjunctive therapy in children with life-threatening amlodipine overdose.