Ghannoum et al listed indications for extracorporeal therapy for a patient with valproic acid poisoning. The authors are from multiple institutions in Canada, Europe and the United States and are members of the EXTRIP (Extracorporeal Treatments in Poisoning) workgroup.
Patient selection: valproic acid poisoning
Molecular weight: 144.211 g
Method of extracorporeal therapy:
(1) intermittent hemodialysis
(2) continuous renal replacement therapy (CRRT)
(3) intermittent hemoperfusion
Indications for extracorporeal therapy:
(1) cerebral edema
(2) coma
(3) shock
(4) valproic acid serum concentration > 130 mg/dL (> 1300 mg/L, > 9015 µmol/L)
(5) valproic acid serum concentration > 90 mg/dL (> 900 mg/L, > 6241 µmol/L) with clinical deterioration
(6) respiratory depression requiring mechanical ventilation
(7) acute hyperammonemia
(8) arterial pH <= 7.1
Goal of therapy:
(1) clinical improvement
(2) serum theophylline concentration < 10 mg/dL (< 100 mg/L, < 700 µmol/L)
