Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10861
Title: Life-threatening sodium valproate overdose: a comparison of two approaches to treatment.
Authors: Licari, Elisa;Calzavacca, Paolo;Warrillow, Stephen J;Bellomo, Rinaldo
Affiliation: Department of Intensive Care, Austin Hospital, Melbourne, Australia.
Issue Date: 1-Dec-2009
Citation: Critical Care Medicine; 37(12): 3161-4
Abstract: To describe two identical cases of severe sodium valproate overdose treated with two different approaches.Case report and review of the literature.Two cases of identical life-threatening valproate (VPA) overdose with high VPA blood levels, markedly elevated ammonia levels and coma.One patient was treated with supportive therapy alone until the development of cerebral edema and seizures; the other was treated with immediate extended hemodialysis followed by high-volume hemodiafiltration.The first patient remained critically ill with elevated VPA and ammonia levels until the development of seizures and life-threatening cerebral edema. After the delayed application of hemofiltration, the patient slowly recovered to be discharged from intensive care on day 11. In contrast, the second patient's VPA and ammonia levels rapidly declined with hemodialysis and hemodiafiltration with rapid clinical improvement and intensive care discharge on day 3.In severe VPA overdose, early intervention with blood purification of suitable intensity was associated with a rapid reduction in VPA and ammonia levels and clinical improvement. This improvement was not seen with supportive therapy alone.
Internal ID Number: 19633542
URI: http://ahro.austin.org.au/austinjspui/handle/1/10861
DOI: 10.1097/CCM.0b013e3181b03245
URL: http://www.ncbi.nlm.nih.gov/pubmed/19633542
Type: Journal Article
Subjects: Adult
Antimanic Agents.administration & dosage.poisoning
Drug Overdose
Emergency Treatment.methods
Female
Humans
Poisoning.therapy
Valproic Acid.administration & dosage.poisoning
Appears in Collections:Journal articles

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