Continuous venovenous hemodiafiltration to treat controlled-release carbamazepine overdose in a pediatric patient
Tulay Sahin Yildiz1, Demet Gedikbasi Toprak, Emin Sami Arisoy
1Department of Anaesthesiology, School of Medicine, University of Kocaeli, Kocaeli, Turkey. tulaysahin00@yahoo.com
Abstract:
Carbamazepine (CBZ) intoxication is an important issue in acute poisoning practice. Highly protein-bound, CBZ is not removed efficiently through conventional hemodialysis. We describe the use of continuous venovenous hemodiafiltration (CVVHDF) in a 2-year-old boy who developed general tonic clonic seizure and respiratory depression due to controlled-release formula of CBZ overdose (peak drug level of > 20 microg.ml(-1), therapeutic range: 5-10 microg.ml(-1)). Serum CBZ concentrations fell to 0.25 microg.ml(-1) at the end of hemodiafiltration. The patient recovered rapidly and was discharged from hospital 4 days from the time of ingestion with no complications or neurologic impairment.
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