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Phenytoin Poisoning

(see full publication)

 

General Recommendation

  • ECTR would be reasonable in selected cases of severe phenytoin poisoning (3D)

 

Indications

  • ECTR is suggested if prolonged coma is present or expected (2D)  

  • ECTR would be reasonable if prolonged incapacitating ataxia is present or expected (3D)

  • We recommend not to perform ECTR solely based on suspected dose of phenytoin ingested (1D)

  • We recommend not to perform ECTR solely based on serum phenytoin concentration (1D)

 

Cessation of ECTR is indicated when

  • ECTR should be discontinued when clinical improvement is apparent (1D)

 

Choice of ECTR

  • Intermittent hemodialysis is the preferred ECTR in phenytoin poisoning (1D)

  • Intermittent hemoperfusion is an acceptable alternative if intermittent hemodialysis is not available (1D)