Hemodialysis versus continuous veno-venous hemodiafiltration in the management of severe valproate overdose.
Valproate intoxication is a relatively common clinical problem that can result in coma, respiratory depression, pancytopenia, hemodynamic instability and death [Fernandez et al. 1996, Franssen et al. 1999]. The drug's relatively low molecular weight, small volume of distribution and saturable protein-binding render it potentially amenable to extracorporeal removal (hemofiltration, hemodialysis or hemoperfusion), but published experience is scarce. This report describes a woman with a potentially fatal sodium valproate overdose, who did not respond to continuous veno-venous hemodiafiltration, but was successfully treated with low-flux hemodialysis. Based on our experience, we recommend hemodialysis for serious valproate intoxication.
Kay
T D
TD
Department of Renal Medicine, Princess Alexandra Hospital, Woolloongabba, Brisbane, Australia.
Playford
H R
HR
Johnson
D W
DW
D062787:Drug Overdose / Q000628:therapy*; D005260:Female; D017583:Hemodiafiltration; D006440:Hemofiltration; D006801:Humans; D008875:Middle Aged; D006435:Renal Dialysis; D012720:Severity of Illness Index; D014635:Valproic Acid / Q000506:poisoning*
D014635:Valproic Acid