The management of acute quinidine intoxication

A 16-year-old patient survived severe intoxication with quinidine. Hypotension, rapidly progressing to oliguria shock, was resistant to the usual therapeutic interventions but responded favorably to the use of an intraaortic balloon pump. Some hemodynamic implications are discussed. Pulmonary edema occurred and was treated with positive end-expiratory pressure. Electrocardiographic disturbances in conduction, transient bradycardia, and recurrent ventricular arrhythmias characterized the initial 36-hour critical period. Unexplained electrolyte abnormalities occurred and further complicated management.