Hypertensive Crisis During Norepinephrine Syringe Exchange: A Case Report

Roland A Snijder, Johannes T A Knape, Toine C G Egberts, Annemoon M D E Timmerman

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

A 67-year critically ill patient suffered from a hypertensive crisis (200 mm Hg) because of a norepinephrine overdose. The overdose occurred when the clinician exchanged an almost-empty syringe and the syringe pump repeatedly reported an error. We hypothesized that an object between the plunger and the syringe driver may have caused the exertion of too much force on the syringe. Testing this hypothesis in vitro showed significant peak dosing errors (up to +572%) but moderate overdose (0.07 mL, +225%) if a clamp was used on the intravenous infusion line and a large overdose (0.8 mL, +2700%) if no clamp was used. Clamping and awareness are advised.

Original languageEnglish
Pages (from-to)178-181
Number of pages4
JournalClinical case reports
Volume8
Issue number7
DOIs
Publication statusPublished - Apr 2017

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