Toxicology reports · 2025
Prolonged intermittent hemodialysis using a standard dialysate flow rate for severe overdose of sustained-release valproic acid: A case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Inoue Hiroki, Yoshikawa Satoshi, Matsukawa Nobuyasu, Shima Atsushi, Nishizawa Takuya, Ueda Takeshi
Аннотация
BACKGROUND: Valproic acid poisoning can be life threatening and may require urgent extracorporeal elimination. In particular, sustained-release formulations pose a challenge, as conventional short-duration intermittent hemodialysis may fail to remove the drug sufficiently because of delayed and prolonged drug absorption. While prolonged intermittent hemodialysis is a rational alternative, its clinical effectiveness and safety in cases of severe sustained-release sodium valproate overdose have not been reported.
CASE: A woman in her 20 s developed coma after ingesting 45 g (approximately 1100 mg/kg) of sustained-release VPA. Prolonged IHD was delivered for 22 h using a blood flow rate (Qb) of 180 mL/min and a dialysate flow rate (Qd) of 500 mL/min. Her consciousness improved in parallel with a marked decline in serum VPA levels, and she was discharged without any neurological sequelae. A two-point, on-dialysis apparent elimination half-life was estimated to be approximately 2.35 h.
CONCLUSION: In this case, prolonged IHD appeared to have an effect in decreasing VPA concentrations and was safely implemented with monitoring.
CASE: A woman in her 20 s developed coma after ingesting 45 g (approximately 1100 mg/kg) of sustained-release VPA. Prolonged IHD was delivered for 22 h using a blood flow rate (Qb) of 180 mL/min and a dialysate flow rate (Qd) of 500 mL/min. Her consciousness improved in parallel with a marked decline in serum VPA levels, and she was discharged without any neurological sequelae. A two-point, on-dialysis apparent elimination half-life was estimated to be approximately 2.35 h.
CONCLUSION: In this case, prolonged IHD appeared to have an effect in decreasing VPA concentrations and was safely implemented with monitoring.