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VOLUME 18 , ISSUE 8 ( August, 2014 ) > List of Articles

CASE REPORT

Successful use of sustained low efficiency dialysis in a case of severe phenobarbital poisoning

Chandrashish Chakravarty, Sayandeep Jana, Abhijit Taraphder

Keywords : Barbiturate, hemodialysis, phenobarbital, poisoning, sustained low efficiency dialysis

Citation Information : Chakravarty C, Jana S, Taraphder A. Successful use of sustained low efficiency dialysis in a case of severe phenobarbital poisoning. Indian J Crit Care Med 2014; 18 (8):530-532.

DOI: 10.4103/0972-5229.138159

License: CC BY-ND 3.0

Published Online: 01-08-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

A 30-year-old female presented with coma and subsequent cardiac arrest caused by phenobarbital overdosage, requiring ventilatory and vasopressor support. She had also developed severe hypoxia following gastric aspiration. Initial therapy, including activated charcoal and forced alkaline diuresis, failed to significantly lower her drug levels and there was minimal neurological improvement. As she was hemodynamically unstable, and unsuitable for conventional dialysis, she was put on sustained low efficiency dialysis (SLED) to facilitate drug removal. SLED resulted in marked reduction in plasma level of phenobarbital, which eventually led to early extubation, improved cognition and aided full recovery. Thus, we concluded that SLED can be an effective alternative in cases of severe phenobarbital poisoning, where conventional hemodialysis or hemoperfusion cannot be initiated, to hasten drug elimination and facilitate early recovery.


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