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Barbiturates Poisoning

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General Recommendation

  • ECTR is recommended in severe long-acting barbiturate poisoning (1D)

 

Indications

ECTR is recommended

  •  If prolonged coma is present or expected (1D)

  •  If shock is present after fluid resuscitation (1D)

  •  If, despite MDAC treatment, toxicity persists (1D)

ECTR is suggested

  •  If, despite MDAC treatment, serum barbiturate concentration rises or remains elevated (2D)

  •  If respiratory depression necessitating mechanical ventilation is present (2D)

 

Choice of ECTR

  •  Intermittent HD is the preferred mode of ECTR of severe barbiturate poisoning (1D)

  •  HP (1D) or CRRT (3D) are acceptable alternative modalities in adults if HD is not available

 

Cessation of ECTR

  •  Cessation of ECTR is indicated when clinical improvement is apparent (1D)