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Aims: Highlighting the efficacy of early initiation of high dose insulin therapy in Beta-blockers overdose over conventional therapy.
Presentation of Case: Authors describe the successful treatment of severe bisoprolol-induced cardiogenic shock in a 74-year-old man using high dose insulin euglycemic therapy. He received intravenous bolus of 1IU/kg of actarapid insulin followed by intravenous infusion of 0.5 IU/kg/hour. The patient hemodynamic parameters improved dramatically within few hours after starting the insulin therapy.
Discussion: Beta-blockers overdose can lead to significant morbidity and mortality due to the often-associated vasopressor-resistant shock. high dose insulin euglycemic therapy is a potential emerging therapy for beta-blockers toxicity with support in the literature from several animal studies, case reports and expert opinion.
Conclusion: High dose insulin euglycemic therapy is a safe and effective method in reversing the hemodynamic consequences induced by beta-blockers overdose and should be used early in the treatment.
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