High-efficiency dialysis for carbamazepine overdose.
BACKGROUND
Carbamazepine intoxication is associated with seizures, coma, arrhythmias, and death. In acute intoxications, charcoal hemoperfusion enhances removal of the drug but is associated with thrombocytopenia, coagulopathy, hypothermia, and hypocalcemia. Alternatively, high-efficiency hemodialysis can be used without the side effects of charcoal hemoperfusion.


METHODS
We report an 18-month-old comatose, convulsing child with plasma carbamazepine 27 microg/mL treated with high efficiency hemodialysis. Therapeutic carbamazepine levels were obtained after 4.5 hours of high-efficiency hemodialysis. The patient developed no untoward side effects, improved clinically, and was subsequently discharged home without sequelae. We conclude that high-efficiency hemodialysis is a safe, effective alternative to charcoal hemoperfusion in the pediatric population.
Schuerer
D J
DJ
C.S. Mott Children's Hospital, University of Michigan, Ann Arbor 48109, USA.
Brophy
P D
PD
Maxvold
N J
NJ
Kudelka
T
T
Bunchman
T E
TE
D000927:Anticonvulsants / Q000097:blood / Q000506:poisoning*; D002220:Carbamazepine / Q000097:blood / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced; D062787:Drug Overdose / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007223:Infant; D006435:Renal Dialysis / Q000295:instrumentation / Q000379:methods*; D012640:Seizures / Q000139:chemically induced; D016896:Treatment Outcome
D000927:Anticonvulsants; D002220:Carbamazepine