Management of Severe Bisoprolol Poisoning Using Continuous Kidney Replacement Therapy: A Case Report and Literature Review.

Case presentation: We report the case of a 65-year-old Caucasian woman who presented to our emergency department following the ingestion of approximately thirty 2.5 mg bisoprolol tablets. Initially stable, she rapidly developed severe bradycardia and hypotension, culminating in cardiogenic-distributive shock that required intubation, aggressive vasoactive support, and advanced metabolic therapies. Due to concurrent hepatic and renal dysfunction impairing drug elimination, continuous kidney replacement therapy (CKRT) was initiated as a supportive intervention and potential drug elimination pathway. The patient's condition progressively improved, leading to complete recovery.

Conclusion: In addition to describing our clinical experience, we provide a concise literature review on the use of CKRT in beta-blocker poisoning, highlighting current knowledge gaps and the need for cautious interpretation in the absence of direct pharmacokinetic measurements.