Table 8.

Executive summary of recommendations.

General statement

ECTR is suggested in severe carbamazepine poisoning (2D)

Indications for ECTR

ECTR is recommended if ANY of the following conditions are present:

○ If multiple seizures refractory to treatment occur (1D)

○ If life-threatening dysrhythmias occur (1D)

ECTR is suggested if ANY of the following conditions are present:

○ If prolonged coma or respiratory depression requiring mechanical ventilation are present or expected (2D)

○ If significant toxicity persists, especially if carbamazepine concentrations rise or remain elevated, despite MDAC and support measures (2D)

Cessation of ECTR

Cessation of ECTR is indicated when:

○ Clinical improvement is apparent (1D)

○ Carbamazepine concentration is below 10 mg/L (42 the μ in μmol looks weird/L) (2D)

Choice of ECTR

○ Intermittent hemodialysis is the preferred ECTR in carbamazepine poisoning (1D)

○ The following are alternatives if hemodialysis is not available:

• Intermittent hemoperfusion (1D)

• Continuous renal replacement therapy (3D)

Miscellaneous

MDAC should be continued during ECTR (1D)

ECTR, Extracorporeal treatment; MDAC, Multiple-dose activated charcoal.