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Title: Combined Hemoperfusion and Continuous Veno-Venous Hemofiltration for Carbamazepine Intoxication.
Austin Authors: Baylis, Simon;Costa-Pinto, Rahul;Hodgson, Sarah;Bellomo, Rinaldo ;Baldwin, Ian C 
Affiliation: The Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia
Intensive Care
Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia
Victorian Poisons Information Centre
Department of Critical Care, The University of Melbourne, Melbourne, Victoria, Australia,
Issue Date: 2022
Date: 2021-12-08
Publication information: Blood Purification 2022; 51(9): 721-725
Abstract: Carbamazepine (CBZ) is a widely used anticonvulsant with a low molecular weight that allows for extracorporeal removal of free drug by both dialytic and hemoperfusion techniques, particularly in a massive overdose where serum protein binding is saturated. This report presents a case of CBZ intoxication where we were able to compare the mass removal of CBZ using hemoperfusion, with the mass removal of CBZ achieved with continuous renal replacement therapy (CRRT) during combined treatment. The Jafron HA230 resin hemoperfusion cartridge was applied in series with the continuous veno-venous hemofiltration (CVVH) circuit. Baseline and ongoing serum drug levels along with further samples from pre- and post-hemoperfusion cartridges and from CVVH effluent were collected. Combined CVVH and resin hemoperfusion therapy in series was associated with a 50% reduction in the CBZ level from 16 mg/L to 8 mg/L over 3 h, far more rapid than that observed with CVVH alone or in the absence of extracorporeal drug clearance in the preceding hours. The combination therapy removed close to 35 mg/h of CBZ. The combination of CRRT and hemoperfusion can be easily deployed, appears safe, and is able to combine the CBZ mass removal achieved with each technique, thus to maximize CBZ extraction.
DOI: 10.1159/000520520
Journal: Blood Purification
PubMed URL: 34879379
PubMed URL:
Type: Journal Article
Subjects: Carbamazepine
Case report
Appears in Collections:Journal articles

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