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General Recommendation

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



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) 





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