Successful treatment of valproic acid overdose with hemodialysis

被引:30
作者
Johnson, LZ
Martinez, I
Fernández, MC
Davis, CP
Kasinath, BS
机构
[1] Univ Texas, Hlth Sci Ctr, Dept Med, Div Nephrol,S Texas Poison Ctr, San Antonio, TX 78284 USA
[2] Univ Texas, Hlth Sci Ctr, Dept Med, Div Emergency Med,S Texas Poison Ctr, San Antonio, TX 78284 USA
[3] Univ Texas, Hlth Sci Ctr, Dept Surg, Div Emergency Med,S Texas Poison Ctr, San Antonio, TX 78284 USA
[4] Univ Texas, Hlth Sci Ctr, Dept Surg, Div Nephrol,S Texas Poison Ctr, San Antonio, TX 78284 USA
关键词
valproic acid; overdose; hemodialysis; coma; poisoning;
D O I
10.1016/S0272-6386(99)70235-0
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
A 43-year-old woman took a large amount of depakote (divalproex, a slow-release form of valproate), became comatose, and developed severe hypotension refractory to fluid resuscitation and high dose vasopressors. The serum valproic acid (VPA) concentration on admission was 1,380 mu g/mL (therapeutic range, 50 to 100 mu g/mL). She also had metabolic acidosis, thrombocytopenia, and normal renal and liver functions. Hemodialysis was initiated 4 hours after presentation, After 6 hours of hemodialysis with a high-flux dialyzer, her serum VPA concentration decreased from 940 mu g/mL to 164 mu g/mL, coincident with improvement in clinical status. The half-life of VPA was reduced to 2.4 hours with hemodialysis, whereas it was 7.2 hours before the procedure. Hemodialysis could be a valuable therapeutic intervention in VPA toxicity. (C) 1999 by the National Kidney Foundation, Inc.
引用
收藏
页码:786 / 789
页数:4
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