7,365
Views
72
CrossRef citations to date
0
Altmetric
Critical Care

Extracorporeal treatment for valproic acid poisoning: Systematic review and recommendations from the EXTRIP workgroup

, , , , , , & show all
Pages 454-465 | Received 30 Jan 2015, Accepted 23 Mar 2015, Published online: 07 May 2015

References

  • Ghannoum M, Nolin TD, Lavergne V, Hoffman RS; EXTRIP workgroup. Blood purification in toxicology: nephrology's ugly duckling. Adv Chronic Kidney Dis 2011; 18:160–166.
  • Lavergne V, Nolin TD, Hoffman RS, Robert D, Gosselin S, Goldfarb DS, et al. The EXTRIP (Extracorporeal Treatments In Poisoning) workgroup: guideline methodology. Clin Toxicol 2012; 50:403–413.
  • Ghannoum M, Nolin TD, Goldfarb DS, Roberts DM, Mactier R, Mowry JB, et al. Extracorporeal treatment for thallium poisoning: recommendations from the EXTRIP Workgroup. Clin J Am Soc Nephrol 2012; 7:1682–1690.
  • Mactier R, Laliberte M, Mardini J, Ghannoum M, Lavergne V, Gosselin S, et al. Extracorporeal treatment for barbiturate poisoning: recommendations from the EXTRIP Workgroup. Am J Kidney Dis 2014; 64:347–358.
  • Gosselin S, Juurlink DN, Kielstein JT, Ghannoum M, Lavergne V, Nolin TD, et al. Extracorporeal treatment for acetaminophen poisoning: recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 2014; 52:856–867.
  • Lavergne V, Ouellet G, Bouchard J, Galvao T, Kielstein JT, Roberts DM, et al. Guidelines for reporting case studies on extracorporeal treatments in poisonings: methodology. Semin Dial 2014; 27:407–414.
  • Yates C, Galvao T, Sowinski KM, Mardini K, Botnaru T, Gosselin S, et al. Extracorporeal treatment for tricyclic antidepressant poisoning: Recommendations from the EXTRIP workgroup. Semin Dial 2014; 27:381–389.
  • Roberts DM, Yates C, Megarbane B, Winchester JF, Maclaren R, Gosselin S, et al. Recommendations for the role of extracorporeal treatments in the management of acute methanol poisoning: a systematic review and consensus statement. Crit Care Med 2015; 43:461–472.
  • Ghannoum M, Yates C, Galvao TF, Sowinski KM, Vo TH, Coogan A, et al. Extracorporeal treatment for carbamazepine poisoning: Systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 2014; 52:993–1004.
  • Decker BS, Goldfarb DS, Dargan PI, Friesen M, Gosselin S, Hoffman RS, et al. Extracorporeal treatment for lithium poisoning: Systematic review and recommendations from the EXTRIP workgroup. Clin J Am Soc Nephrol 2015; pii: CJN.10021014. [Epub ahead of print].
  • Mowry JB, Spyker DA, Cantilena LR, Jr., McMillan N, Ford M. 2013 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 31st Annual Report. Clin Toxicol (Phila) 2014; 52:1032–1283.
  • Klotz U, Antonin KH. Pharmacokinetics and bioavailability of sodium valproate. Clin Pharmacol Ther 1977; 21:736–743.
  • Spiller HA, Krenzelok EP, Klein-Schwartz W, Winter ML, Weber JA, Sollee DR, et al. Multicenter case series of valproic acid ingestion: serum concentrations and toxicity. J Toxicol Clin Toxicol 2000; 38:755–760.
  • van den Broek MP, Sikma MA, Ververs TF, Meulenbelt J. Severe valproic acid intoxication: case study on the unbound fraction and the applicability of extracorporeal elimination. Eur J Emerg Med 2009; 16:330–332.
  • Sztajnkrycer MD. Valproic acid toxicity: overview and management. J Toxicol Clin Toxicol 2002; 40:789–801.
  • Thanacoody RH. Extracorporeal elimination in acute valproic acid poisoning. Clin Toxicol (Phila) 2009; 47:609–616.
  • Franssen EJ, van Essen GG, Portman AT, de Jong J, Go G, Stegeman CA, Uges DR. Valproic acid toxicokinetics: Serial hemodialysis and hemoperfusion. Ther Drug Monit 1999; 21:289–292.
  • Johnson LZ, Martinez I, Fernandez MC, Davis CP, Kasinath BS. Successful treatment of valproic acid overdose with hemodialysis. Am J Kidney Dis 1999; 33:786–789.
  • Isbister GK, Balit CR, Whyte IM, Dawson A. Valproate overdose: A comparative cohort study of self poisonings. Br J Clin Pharmacol 2003; 55:398–404.
  • Vale J, Krenzelok, EP., Barceloux VD. Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1999; 37:731–751.
  • Lheureux PE, Hantson P. Carnitine in the treatment of valproic acid-induced toxicity. Clin Toxicol (Phila) 2009; 47:101–111.
  • Perrott J, Murphy NG, Zed PJ. L-carnitine for acute valproic acid overdose: a systematic review of published cases. Ann Pharmacother 2010; 44:1287–1293.
  • Lheureux PE, Penaloza A, Zahir S, Gris M. Science review: carnitine in the treatment of valproic acid-induced toxicity - what is the evidence? Crit Care 2005; 9:431–440.
  • Mock CM, Schwetschenau KH. Levocarnitine for valproic-acid-induced hyperammonemic encephalopathy. Am J Health-Syst Pharm 2012; 69:35–39.
  • Lewis C, Deshpande A, Tesar GE, Dale R. Valproate-induced hyperammonemic encephalopathy: A brief review. Curr Med Res Opin 2012; 28:1039–1042.
  • Rivers C. Valproic acid poisoning. UpToDate, Post TW (Ed). 2013.
  • Valproate De Sodium. Toxinz, National Poisons Centre, New Zealand. 2015.
  • Doyon S. Anticonvulsants. In: Hoffman RS, Howland MA, Lewin NA, Nelson L, Goldfrank LR, Flomenbaum N, editors. Goldfrank's toxicologic emergencies. 10th edition/ed. New York: McGraw Hill; 2015. p. 645–656.
  • Appraisal of guidelines for research & evaluation. AGREE instrument. London: The AGREE Collaboration; 2001.
  • Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ 2004; 328:1490.
  • Fitch K, Bernstein SJ, Aguilar MD, Burnand B, LaCalle JR, Lazaro P, et al. The RAND/UCLA Appropriateness Method User's Manual. Santa Monica, USA: RAND; 2011. Available from: http://www.rand.org/.
  • Singh SM, McCormick BB, Mustata S, Thompson M, Prasad GV. Extracorporeal management of valproic acid overdose: a large regional experience. J Nephrol 2004; 17:43–49.
  • Al Aly Z, Yalamanchili P, Gonzalez E. Extracorporeal management of valproic acid toxicity: a case report and review of the literature. Semin Dial 2005; 18:62–66.
  • Alluin A, Jezequel J, Gauthier N, Desmaretz JL, Canevet C. Acute valproic acid intoxication: interest of a treatment by extracoporeal elimination combined with L-carnitine. Ann Fr Anesth Reanim 2011; 30:752–754.
  • Auinger K, Muller V, Rudiger A, Maggiorini M. Valproic acid intoxication imitating brain death. Am J Emerg Med 2009; 27:1177 e5–6.
  • Bergmann I, Bannister K. Successful treatment of a severe sodium valproate intoxication with haemodialysis. Nephrology 2010; 15:85.
  • Blayac D, Roch A, Michelet P, De Francheschi E, Auffray JP. [Deep lactic acidosis after valproate self-poisoning]. Ann Fr Anesth Reanim 2004; 23:1007–1110.
  • Bohm M, Meencke HJ. Coma following valproate intoxication. Aktuelle Neurologie 2002; 29:516–519.
  • Brubacher JR, Dahghani P, McKnight D. Delayed toxicity following ingestion of enteric-coated divalproex sodium (Epival). J Emerg Med 1999; 17:463–467.
  • Chou HF, Yang RC, Chen CY, Jong YJ. Valproate-induced hyperammonemic encephalopathy. Pediatr Neonatol 2008; 49:201–204.
  • Colak A, Memis D, Guzel A, Cerci H, Gurkaynak B. Valproic acid intoxication with suicide attempt in a pediatric patient. Pediatr Int 2011; 53:781–783.
  • Davison AS, Milan AM, Roberts NB. The consequences of valproate overdose. Clin Chem 2011; 57:1233–1237.
  • Deras P, Gignon L, Toumi M, Louart G, Muller L, Boyer JC, et al. Lactic acidosis after voluntary intoxication with valproic acid. Ann Fr Anesth Reanim 2010; 29:63–64.
  • Dharnidharka VR, Fennell RS 3rd, Richard GA. Extracorporeal removal of toxic valproic acid levels in children. Pediatr Nephrol 2002; 17:312–315.
  • Dichtwald S, Dahan E, Adi N, Moses A, Sorkine P. Molecular adsorbent recycling system therapy in the treatment of acute valproic acid intoxication. Isr Med Assoc J 2010; 12:307–308.
  • Eyer F, Felgenhauer N, Gempel K, Steimer W, Gerbitz KD, Zilker T. Acute valproate poisoning: pharmacokinetics, alteration in fatty acid metabolism, and changes during therapy. J Clin Psychopharmacol 2005; 25:376–380.
  • Fernandez MC, Walter FG, Kloster JC, Do SM, Brady LA, Villarin A, et al. Hemodialysis and hemoperfusion for treatment of valproic acid and gabapentin poisoning. Vet Hum Toxicol 1996; 38:438–443.
  • Field J, Daly FS. Continuous veno-venous haemodiafiltration in sodium valproate overdose complicated by cerebral oedema: a case report. Crit Care Resusc 2002; 4:173–176.
  • Frifelt JJ, Wanscher MC, Wienholtz G, Horwitz N, Brockhattingen A. Acute valproate poisoning. Ugeskr Laeger 1987; 149:3255–3257.
  • George SM. Therapeutic plasma exchange for valproic acid poisoning - an innovative approach. Am J Kidney Dis 2009; 53:A37.
  • Goncalves JA, Santos C, Montalban JM, Filipe RA, Chorao R, Freixo J, et al. Continuous venovenous haemodiafiltration as a solution for acute intoxication with sodium valproate. Nefrologia 2010; 30:134–135.
  • Gracia R, Shepherd G, Rivera W, Keyes DC. Prolonged QTc with a massive valproic acid overdose. Clin Toxicol (Phila) 2004; 42:557.
  • Graudins A, Aaron CK. Delayed peak serum valproic acid in massive divalproex overdose—treatment with charcoal hemoperfusion. J Toxicol Clin Toxicol 1996; 34:335–341.
  • Guillaume CP, Stolk L, Dejagere TF, Kooman JP. Successful use of hemodialysis in acute valproic acid intoxication. J Toxicol Clin Toxicol 2004; 42:335–336.
  • He S, Rifkin SI, Durr JA. Hemoperfusion (HP) vs hemodialysis (HD) in a case of combined overdose (OD) with acetaminophen and valproic acid (VPA): implications of our findings. Am J Kidney Dis 2010; 55:A64.
  • Hicks LK, McFarlane PA. Valproic acid overdose and haemodialysis. Nephrol Dial Transplant 2001; 16:1483–1486.
  • Hydzik P, Wilimowska J, Groszek B. Liver albumin dialysis (MARS) in severe valproic acid poisoning. Clin Toxicol 2009; 47:482.
  • Jacobs FM, Pinot G, Prat D, Pilorge C, Brivet F. Valproic acid overdose and continuous venovenous hemodiafiltration. NDT plus 2008; 1:60–61.
  • Jezequel J, Gauthier N, Alluin A, Desmaretz JL, Guenault N, Desaintfuscien E, et al. Severe valproic acid poisoning: Place of antidotal treatment and extracorporeal removal techniques. Reanimation 2010; 19:587–92.
  • Jung J, Eo E, Ahn KO. A case of hemoperfusion and L-carnitine management in valproic acid overdose. Am J Emerg Med 2008; 26:388 e3–4.
  • Kane SL, Constantiner M, Staubus AE, Meinecke CD, Sedor JR. High-flux hemodialysis without hemoperfusion is effective in acute valproic acid overdose. Ann Pharmacother 2000; 34:1146–1151.
  • Kay TD, Playford HR, Johnson DW. Hemodialysis versus continuous veno-venous hemodiafiltration in the management of severe valproate overdose. Clin Nephrol 2003; 59:56–58.
  • Khan E, Huggan P, Celi L, MacGinley R, Schollum J, Walker R. Sustained low-efficiency dialysis with filtration (SLEDD-f) in the management of acute sodium valproate intoxication. Hemodial Int 2008; 12:211–214.
  • Kielstein JT, Woywodt A, Schumann G, Haller H, Fliser D. Efficiency of high-flux hemodialysis in the treatment of valproic acid intoxication. J Toxicol Clin Toxicol 2003; 41:873–876.
  • Kostic M, Pan C, Leikin J, Gummin D. Critical valproate toxicity reversed with hemodialysis in a toddler. Clin Toxicol 2010; 48:606.
  • Kroll P, Nand C. Hemodialysis in the treatment of valproic acid overdose. J Clin Psychiatry 2002; 63:78–79.
  • Lavigne T, Meziani F, Kremer H, Castelain V, P. B, Jaeger A. Severe valproic acid poisoning treated with l-carnitine and hemodialysis. Lack of correlation between symptoms, serum valproic acid concentrations and ammonemia. Clin Toxicol (Phila). 2004; 42:560.
  • Letonja M, Petrovic D, Brvar M, Bunc M. Cardiotoxicity in acute valproate poisoning. Clin Toxicol 2009; 47:454–455.
  • Licari E, Calzavacca P, Warrillow SJ, Bellomo R. Life-threatening sodium valproate overdose: a comparison of two approaches to treatment. Crit Care Med 2009; 37:3161–3164.
  • Luzhnikov EA, Sukhodolova GN, Ostapenko YN, Kovalenko LA, Kovalchuk AS, Dolginov DM. A case of successful therapy in acute valproic acid poisoning in a child using hemodiafiltration. Clin Toxicol 2010; 48:248.
  • Matsumoto J, Ogawa H, Maeyama R, Okudaira K, Shinka T, Kuhara T, et al. Successful treatment by direct hemoperfusion of coma possibly resulting from mitochondrial dysfunction in acute valproate intoxication. Epilepsia 1997; 38:950–953.
  • Meek MF, Broekroelofs J, Yska JP, Egbers PH, Boerma EC, van der Voort PH. Valproic acid intoxication: Sense and non-sense of haemodialysis. Neth J Med 2004; 62:333–336.
  • Mestrovic J, Filipovic T, Polic B, Stricevic L, Omazic A, Kuzmanic-Samija R, Markić J. Life-threatening valproate overdose successfully treated with haemodialysis. Arh Hig Rada Toksikol 2008; 59:295–298.
  • Meyer S, Kuhlmann MK, Peters FT, Limbach HG, Lindinger A. Severe valproic acid intoxication is associated with atrial tachycardia: secondary detoxication by hemoperfusion. Klin Padiatr 2005; 217:82–85.
  • Min YG, Tse ML. Image in toxicology: pseudo-subarachnoid hemorrhage in a case of severe valproic acid poisoning. Clin Toxicol 2011; 49:699–700.
  • Minari M, Maggiore U, Tagliavini D, Rotelli C, Cabassi A, David S, Fiaccadori E. Severe acute valproic acid intoxication successfully treated with hemodiafiltration without hemoperfusion. Ann Emerg Med 2002; 39:204–205.
  • Minville V, Roche Tissot C, Samii K. [Haemodialysis, L-carnitine therapy and valproic acid overdose]. Ann Fr Anesth Reanim 2004; 23:357–360.
  • Mortensen PB, Hansen HE, Pedersen B, Hartmann-Andersen F, Husted SE. Acute valproate intoxication: biochemical investigations and hemodialysis treatment. Int J Clin Pharmacol Ther Toxicol 1983; 21:64–68.
  • Nasa P, Sehrawat D, Kansal S, Chawla R. Effectiveness of hemodialysis in a case of severe valproate overdose. Indian J Crit Care Med 2011; 15:120–122.
  • Novotny WE, Meggs W, Hymes L, Ford M. Mild valproic acid poisoning and development of near fatal cerebral edema. Clin Toxicol 2014; 52:329–330.
  • Peces R, Fernandez EJ, Sanchez RJ, Peces C, Montero A, Selgas R. [Hemoperfusion in the treatment of acute valproic acid intoxication]. Nefrologia 2007; 27:370–373.
  • Pertoldi F, D’Orlando L, Galliazzo S, Mercante WP. Haemodialysis in the management of severe valproic acid overdose. Clin Intensive Care 1997; 8:244–246.
  • Pons S, Gonzva J, Prunet B, Gaillard T, Brisou P, Vest P, Emile L. Acute overdose of enteric-coated valproic acid and olanzapine: unusual presentation and delayed toxicity. Clin Toxicol 2012; 50:268.
  • Ray S, Skellett S. Valproate toxicity in a child: two novel observations. Clin Toxicol (Phila) 2013; 51:60.
  • Rahman MH, Haqqie SS, McGoldrick MD. Acute hemolysis with acute renal failure in a patient with valproic acid poisoning treated with charcoal hemoperfusion. Hemodial Int 2006; 10:256–259.
  • Roodhooft AM, Van Dam K, Haentjens D, Verpooten GA, Van Acker KJ. Acute sodium valproate intoxication: occurrence of renal failure and treatment with haemoperfusion-haemodialysis. Eur J Pediatr 1990; 149:363–364.
  • Siebenlist D, Klobe R, Gattenlohner W. Plasmaperfusion in the treatment of a severe sodium valproate intoxication. Intensivmedizin und Notfallmedizin 1991; 28:365–367.
  • Stankova E, Mechkarska B, Gesheva M. Acute poisoning with valproic acid - a case report. Acta Medica Bulgarica 2007; 34:32–40.
  • Sliwkiewicz K, Winnicka R, Rzepecki J, Kolacinski Z, Krakowiak A. Acute intoxication with valproic acid, treated with hemodialysis/hemoperfusion in series - case report. Clin Toxicol 2010; 48:248.
  • Tank JE, Palmer BF. Simultaneous “in series” hemodialysis and hemoperfusion in the management of valproic acid overdose. Am J Kidney Dis 1993; 22:341–344.
  • Temel V, Arikan M, Temel G. High-flux hemodialysis and levocarnitine in the treatment of severe valproic Acid intoxication. Case Rep Emerg Med 2013; 2013:526469.
  • Tsai MF, Chen CY, Chiu KC. Valproate-induced hyperammonemic encephalopathy treated by hemodialysis. Ren Fail 2008; 30:822–824.
  • Tominaga A. Case of valproic acid overdose treated by hemodialysis. Chudoku Kenkyu 2014; 27:45–46.
  • van der Merwe AC, Albrecht CF, Brink MS, Coetzee AR. Sodium valproate poisoning. A case report. S Afr Med J 1985; 67:735–736.
  • van der Wouden EA, Dekkers A, Kruis HM, van Geijlswijk IM, Tjan DH, Feith GW. Extracorporeal elimination in acute valproate intoxication. BMJ Case Rep 2009; 2009: pii: bcr06.2008.0337. doi: 10.1136/bcr.06.2008.0337. Epub 2009 Feb 2.
  • van Kuelen JG, van Wijk JA, Touw DJ, van der Deure J, Markhorst DG, Gemke RJ. Effectiveness of haemofiltration in valproic acid intoxication. Acta Paediatr 2001; 90:958–959.
  • Williams S, Clark R. Hemodialysis of a valproic acid poisoning. J Toxicol Clin Toxicol 1995; 33:491.
  • Von Bardeleben RS, Sturer A, Weilemann LS. Valproic acid intoxications in 96 documented cases 1995–1998: the role of hemoperfusion in therapy. Clin Toxicol (Phila) 1998; 36:471–472.
  • Wolze O, Summa JD, Platt D, Degel F, Eicher H. A report of a severe sodium valproate poisoning case and its treatment by hemoperfusion and forced diuresis. Intensivmedizin und Notfallmedizin 1988; 25:281–284.
  • Bastiaans DE, van Uden IW, Ruiterkamp RA, de Jong BA. Removal of valproic acid by plasmapheresis in a patient treated for multiple sclerosis. Ther Drug Monit 2013; 35:1–3.
  • Lai CW, Leppik IE, Jenkins DC, Sood P. Epilepsy, myasthenia gravis, and effect of plasmapheresis on antiepileptic drug concentrations. Arch Neurol 1990; 47:66–68.
  • Marbury TC, Lee CS, Bruni J. Hemodialysis of valproic acid in uremic patients. Dial Transplant 1980; 9:961–964.
  • Orr JM, Farrell K, Abbott FS, Ferguson S, Godolphin WJ. The effects of peritoneal dialysis on the single dose and steady state pharmacokinetics of valproic acid in a uremic epileptic child. Eur J Clin Pharmacol 1983; 24:387–390.
  • Gubensek J, Buturovic-Ponikvar J, Ponikvar R, Cebular B. Hemodiafiltration and high-flux hemodialysis significantly reduce serum valproate levels inducing epileptic seizures: case report. Blood Purif 2008; 26:379–380.
  • Kochen W, Schneider A, Ritz A. Abnormal metabolism of valproic acid in fatal hepatic failure. Eur J Pediatr 1983; 141:30–35.
  • Kandrotas RJ, Love JM, Gal P, Oles KS. The effect of hemodialysis and hemoperfusion on serum valproic acid concentration. Neurology 1990; 40:1456–1458.
  • Bertrand YM, Hermant A, Mahieu P, Roels J. Intracranial pressure changes in patients with head trauma during haemodialysis. Intensive Care Med 1983; 9:321–323.
  • Shi ZW, Wang ZG. Acute cerebral and pulmonary edema induced by hemodialysis. Chin Med J (Engl) 2008; 121:1003–1009.
  • Krane NK. Intracranial pressure measurement in a patient undergoing hemodialysis and peritoneal dialysis. Am J Kidney Dis 1989; 13:336–339.
  • Lin CM, Lin JW, Tsai JT, Ko CP, Hung KS, Hung CC, et al. Intracranial pressure fluctuation during hemodialysis in renal failure patients with intracranial hemorrhage. Acta Neurochir Suppl 2008; 101:141–144.
  • Bain MA, Faull R, Milne RW, Evans AM. Oral L-carnitine: metabolite formation and hemodialysis. Curr Drug Metab 2006; 7:811–816.
  • Fornasini G, Upton RN, Evans AM. A pharmacokinetic model for L-carnitine in patients receiving haemodialysis. Br J Clin Pharmacol 2007; 64:335–345.
  • Vernez L, Dickenmann M, Steiger J, Wenk M, Krahenbuhl S. Effect of L-carnitine on the kinetics of carnitine, acylcarnitines and butyrobetaine in long-term haemodialysis. Nephrol Dial Transplant 2006; 21:450–458.
  • Chyka PA, Holley JE, Mandrell TD, Sugathan P. Correlation of drug pharmacokinetics and effectiveness of multiple-dose activated charcoal therapy. Ann Emerg Med 1995; 25:356–362.
  • al-Shareef A, Buss DC, Shetty HG, Ali N, Routledge PA. The effect of repeated-dose activated charcoal on the pharmacokinetics of sodium valproate in healthy volunteers. Br J Clin Pharmacol 1997; 43:109–111.
  • Farrar HC, Herold DA, Reed MD. Acute valproic acid intoxication: enhanced drug clearance with oral-activated charcoal. Crit Care Med 1993; 21:299–301.
  • Kronfol NO, Lau AH, Colon-Rivera J, Libertin CL. Effect of CAVH membrane types on drug-sieving coefficients and clearances. ASAIO Trans 1986; 32:85–87.
  • Churchwell MD, Pasko DA. Enhanced valproic acid dialytic clearance with an albumin-based dialysate in continuous venovenous hemodialysis. Blood Purif 2005; s23:154–155.
  • Siegel NJ, Brown RS. Peritoneal clearance of ammonia and creatinine in a neonate. J Pediatr 1973; 82:1044–1046.
  • Lai YC, Huang HP, Tsai IJ, Tsau YK. High-volume continuous venovenous hemofiltration as an effective therapy for acute management of inborn errors of metabolism in young children. Blood Purif 2007; 25:303–308.
  • Wiegand C, Thompson T, Bock GH, Mathis RK, Kjellstrand CM, Mauer SM. The management of life-threatening hyperammonemia: a comparison of several therapeutic modalities. J Pediatr 1980; 96:142–144.
  • Rutledge SL, Havens PL, Haymond MW, McLean RH, Kan JS, Brusilow SW. Neonatal hemodialysis: effective therapy for the encephalopathy of inborn errors of metabolism. J Pediatr 1990; 116:125–128.
  • Chen CY, Chen YC, Fang JT, Huang CC. Continuous arteriovenous hemodiafiltration in the acute treatment of hyperammonaemia due to ornithine transcarbamylase deficiency. Ren Fail 2000; 22:823–836.
  • Slack AJ, Auzinger G, Willars C, Dew T, Musto R, Corsilli D, et al. Ammonia clearance with haemofiltration in adults with liver disease. Liver Int 2014; 34:42–48.
  • Cordoba J, Blei AT, Mujais S. Determinants of ammonia clearance by hemodialysis. Artif Organs 1996; 20:800–803.
  • Dupuis RE, Lichtman SN, Pollack GM. Acute valproic acid overdose. Clinical course and pharmacokinetic disposition of valproic acid and metabolites. Drug Saf 1990; 5:65–71.
  • Bouchard J, Roberts DM, Roy L, Ouellet G, Decker BS, Mueller BA, et al. Principles and operational parameters to optimize poison removal with extracorporeal treatments. Semin Dial 2014; 27:371–380.
  • Maslov OG, Brusin KM, Kochmashev VF, Sentsov VG. Comparative evaluation of methods of extracorporeal detoxification in acute carbamazepine poisoning. Klinicheskaia Toksikologiia 2011; 12: 1169–1179.
  • Ghannoum M, Bouchard J, Nolin TD, Ouellet G, Roberts DM. Hemoperfusion for the treatment of poisoning: technology, determinants of poison clearance, and application in clinical practice. Semin Dial 2014; 27:350–361.
  • Shannon MW. Comparative efficacy of hemodialysis and hemoperfusion in severe theophylline intoxication. Acad Emerg Med 1997; 4:674–678.
  • Acharya S, Bussel JB. Hematologic toxicity of sodium valproate. J Pediatr Hematol Oncol 2000; 22:62–65.
  • Ghannoum M, Roberts DM, Hoffman RS, Ouellet G, Roy L, Decker BS, Bouchard J. A stepwise approach for the management of poisoning with extracorporeal treatments. Semin Dial 2014; 27:362–370.
  • Richardson D, Bellamy M. Intracranial hypertension in acute liver failure. Nephrol Dial Transplant 2002; 17:23–27.
  • Ghannoum M, Gosselin S. Enhanced poison elimination in critical care. Adv Chronic Kidney Dis 2013; 20:94–101.
  • Ouellet G, Bouchard J, Ghannoum M, Decker BS. Available extracorporeal treatments for poisoning: overview and limitations. Semin Dial 2014; 27:342–349.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.