Korean J Nephrol.  1999 Nov;18(6):998-1002.

Successful Hemodialysis in Acute Phenobarbital Intoxication

• Kim SK
• Seo CJ
• Kang MB
• Jeong JB
• Cha MK
• Lee JH
• Kim ST
• Lee JK
• Lee HE
• Kim C

Abstract

Phenobarbital is one of long-acting barbiturate with low lipid solubility and used frequently as an anticonvulsant. However, in severe intoxication, hypotension and respiratory arrest are the major causes of prehospital mortality. Mortality is 3M for blood levels over HO pg/mL and estimated lethal adult dose is 6-10g. No effective antidotes are available. We report a case of phenobarbital intoxication in a 29-year-old female, treated successfully with hemodialysis. She was found corhatose on the day of admission and was alleged to have taken 30g of phenobarbital. On physical examination, the blood pressure was 80/60mmHg, and pulse, 97/min. There was no respiration. Pupil was dilated fully. Corneal and deep tendon reflexes were absent. There was no response to painful stimuli. She was treated conservatively with mechanical ventilation, gut decontamination and forced diuresis. Hemodialysis was tried to remove excess phenobarbital for 13 hours. The blood phenobarbital level at admission was 162.2 pg/ mL, which was decreased to 114.4pg/mL after first session of hemodialysis. On the fifth hospital day, blood level decreased to 41.8 pg/mL and she regained her consciousness. She was discharged on the 10th hospital day without major sequelae.

MeSH Terms

Adult
Antidotes
Blood Pressure
Consciousness
Decontamination
Diuresis
Female
Humans
Hypotension
Mortality
Phenobarbital*
Physical Examination
Pupil
Reflex, Stretch
Renal Dialysis*
Respiration
Respiration, Artificial
Solubility
Antidotes
Phenobarbital