Hemodialysis and hemoperfusion for treatment of valproic acid and gabapentin poisoning

Miguel C. Fernandez, Frank G. Walter, James C. Kloster, Sean M. O'Brien, Lesley A. Brady, Al Villarin, Stephen J. Ruffenach, Eric H. Prosnitz, Julia V. Salmon

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21 Scopus citations

Abstract

A 31-y-old epileptic man developed coma and shock after suicidally ingesting large amounts of valproic acid and gabapentin. His peak valproic acid level was 1306.9 μg/mL (therapeutic range = 30-100 μg/mL). His peak gabapentin level was 60.0 μg/mL (therapeutic range = 2.0-8.0 μg/mL). His hypotension was refractory to crystalloid and pressor infusions, but resolved during concurrent hemoperfusion and hemodialysis to enhance elimination of valproic acid. Concurrent hemoperfusion and hemodialysis, in series, produced a maximum valproic acid plasma clearance of 55.4 mL/min versus a maximum reported intrinsic valproic acid plasma clearance of 10.6 mL/min. Concurrent hemoperfusion and hemodialysis, in series, should be considered in hemodynamically unstable patients with valproic acid poisoning whose clinical condition is worsening in spite of aggressive supportive care.

Original languageEnglish (US)
Pages (from-to)438-443
Number of pages6
JournalVeterinary and Human Toxicology
Volume38
Issue number6
StatePublished - Dec 1 1996

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ASJC Scopus subject areas

  • Toxicology
  • veterinary(all)
  • Health, Toxicology and Mutagenesis

Cite this

Fernandez, M. C., Walter, F. G., Kloster, J. C., O'Brien, S. M., Brady, L. A., Villarin, A., Ruffenach, S. J., Prosnitz, E. H., & Salmon, J. V. (1996). Hemodialysis and hemoperfusion for treatment of valproic acid and gabapentin poisoning. Veterinary and Human Toxicology, 38(6), 438-443.