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01-11-2019 | Paracetamol | Consensus Conference

Renal replacement therapy in the management of intoxications in children: recommendations from the Pediatric Continuous Renal Replacement Therapy (PCRRT) workgroup

Authors: Rupesh Raina, Manpreet K Grewal, Martha Blackford, Jordan M. Symons, Michael J. G. Somers, Christoph Licht, Rajit K Basu, Sidharth Kumar Sethi, Deepa Chand, Gaurav Kapur, Mignon McCulloch, Arvind Bagga, Vinod Krishnappa, Hui-Kim Yap, Marcelo de Sousa Tavares, Timothy E Bunchman, Michelle Bestic, Bradley A Warady, Maria Díaz-González de Ferris

Published in: Pediatric Nephrology | Issue 11/2019

Abstract

Background

Intentional or unintentional ingestions among children and adolescents are common. There are a number of ingestions amenable to renal replacement therapy (RRT).

Methods

We systematically searched PubMed/Medline, Embase, and Cochrane databases for literature regarding drugs/intoxicants and treatment with RRT in pediatric populations. Two experts from the PCRRT (Pediatric Continuous Renal Replacement Therapy) workgroup assessed titles, abstracts, and full-text articles for extraction of data. The data from the literature search was shared with the PCRRT workgroup and two expert toxicologists, and expert panel recommendations were developed.

Results and Conclusions

We have presented the recommendations concerning the use of RRTs for treatment of intoxications with toxic alcohols, lithium, vancomycin, theophylline, barbiturates, metformin, carbamazepine, methotrexate, phenytoin, acetaminophen, salicylates, valproic acid, and aminoglycosides.

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Gummin DD, Mowry JB, Spyker DA, Brooks DE, Osterthaler KM, Banner W (2018) 2017 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 35th annual report. Clin Toxicol (Phila) 56(12):1213–1415CrossRef

Cox RD, Phillips WJ (2004) Ethylene glycol toxicity. Mil Med 169(8):660–663CrossRefPubMed

Stapenhorst L, Hesse A, Hoppe B (2008) Hyperoxaluria after ethylene glycol poisoning. Pediatr Nephrol 23(12):2277–2279CrossRefPubMed

Tadokoro M, Ozono Y, Hara K, Taguchi T, Harada T, Ideguchi M, Senju M (1995) A case of acute renal failure due to ethylene glycol intoxication. Nihon Jinzo Gakkai Shi 37(6):353–356

Brown MJ, Shannon MW, Woolf A, Boyer EW (2001) Childhood methanol ingestion treated with fomepizole and hemodialysis. Pediatrics 108(4):E77CrossRefPubMed

Loza R, Rodriguez D (2014) A case of methanol poisoning in a child. Case Rep Nephrol 2014:652129. https://doi.org/10.1155/2014/652129 CrossRefPubMedPubMedCentral

Sutton TL, Foster RL, Liner SR (2002) Acute methanol ingestion. Pediatr Emerg Care 18(5):360–363CrossRefPubMed

Gormley NJ, Bronstein AC, Rasimas JJ et al (2012) The rising incidence of intentional ingestion of ethanol containing hand sanitizers. Crit Care Med 40(1):290–294CrossRefPubMedPubMedCentral

Mecikalski MB, Depner TA (1982) Peritoneal dialysis for isopropanol poisoning. West J Med 137(4):322–325PubMedPubMedCentral

10.

Meyer RJ, Flynn JT, Brophy PD et al (2001) Hemodialysis followed by continuous hemofiltration for treatment of lithium intoxication in children. Am J Kidney Dis 37(5):1044–1047CrossRefPubMed

11.

Panzarino VM, Feldstein TJ, Kashtan CE (1998) Charcoal hemoperfusion in a child with vancomycin overdose and chronic renal failure. Pediatr Nephrol 12(1):63–64CrossRefPubMed

12.

Stidham T, Reiter PD, Ford DM, Lum GM, Albietz J (2011) Successful utilization of high-flux hemodialysis for treatment of vancomycin toxicity in a child. Case Rep Pediatr 2011:678724

13.

Yaman A, Kendirli T, Odek C, Azapağası E, Erkol H, Pişkin İE, Teber-Tıraş S, Yalçınkaya F (2016) Severe theophylline poisoning treated with continuous venovenous hemodialysis in a child. Turk J Pediatr 58(3):297–300

14.

Soylemezoglu O, Bakkaloglu A, Yigit S, Saatci U (1993) Haemodialysis treatment in phenobarbital intoxication in infancy. Int Urol Nephrol 25(1):111–113CrossRefPubMed

15.

Kihtir HS, Yildirim HM, Yesilbas O, Duramaz BB, Sevketoglu E (2016) Single-pass albumin dialysis in a child aged six months with phenobarbital poisoning. Turk Pediatri Ars 51(4):228–230CrossRefPubMedPubMedCentral

16.

Lacher M, Hermanns-Clausen M, Haeffner K, Brandis M, Pohl M (2005) Severe metformin intoxication with lactic acidosis in an adolescent. Eur J Pediatr 164(6):362–365CrossRefPubMed

17.

Soyoral YU, Begenik H, Emre H, Aytemiz E, Ozturk M, Erkoc R (2011) Dialysis therapy for lactic acidosis caused by metformin intoxication: presentation of two cases. Hum Exp Toxicol 30(12):1995–1997CrossRefPubMed

18.

Harvey B, Hickman C, Hinson G, Ralph T, Mayer A (2005) Severe lactic acidosis complicating metformin overdose successfully treated with high-volume venovenous hemofiltration and aggressive alkalinization. Pediatr Crit Care Med 6(5):598–601CrossRefPubMed

19.

Yildiz TS, Toprak DG, Arisoy ES, Solak M, Toker K (2006) Continuous venovenous hemodiafiltration to treat controlled-release carbamazepine overdose in a pediatric patient. Paediatr Anaesth 16(11):1176–1178PubMed

20.

Askenazi DJ, Goldstein SL, Chang IF, Elenberg E, Feig DI (2004) Management of a severe carbamazepine overdose using albumin-enhanced continuous venovenous hemodialysis. Pediatrics 113(2):406–409CrossRefPubMed

21.

Duzova A, Baskin E, Usta Y, Ozen S (2001) Carbamazepine poisoning: treatment with plasma exchange. Hum Exp Toxicol 20(4):175–177CrossRefPubMed

22.

Chan WK, Hui WF (2016) Sequential use of hemoperfusion and single-pass albumin dialysis can safely reverse methotrexate nephrotoxicity. Pediatr Nephrol 31(10):1699–1703CrossRefPubMed

23.

Saland J, Leavey PJ, Bash RO et al (2002) Effective removal of methotrexate by high-flux hemodialysis. Pediatr Nephrol 17:825CrossRefPubMed

24.

Nemoto T, Imai C, Kaneko U et al (2009) Effect of charcoal hemoperfusion for removal of plasma methotrexate in a patient with acute renal failure. Pediatr Hematol Oncol 26(7):520–525CrossRefPubMed

25.

Cecyn KZ, Lee J, Oguro T, Petrilli AS, Bordin JO (2003) Use of plasma exchange in methotrexate removal in a patient with osteosarcoma and acute renal insufficiency. Am J Hematol 72(3):209–211CrossRefPubMed

26.

Singh S (2015) Tandem plasmapheresis with hemodialysis in phenytoin intoxication: a case report. Int J Adv Med 2(3):269–271CrossRef

27.

Kumar PP, Lingappa L, Shah MA, Shaikh FA (2012) Charcoal hemoperfusion 150 for phenytoin intoxication. Indian Pediatr 49(2):152–153PubMed

28.

Ghannoum M, Kazim S, Grunbaum AM, Villeneuve E, Gosselin S (2016) Massive acetaminophen overdose: effect of hemodialysis on acetaminophen and acetylcysteine kinetics. Clin Toxicol (Phila) 54(6):519–522CrossRef

29.

Muniandy RK, Sinnathamby V (2012) Salicylate toxicity from ingestion of traditional massage oil. BMJ Case Rep. https://doi.org/10.1136/bcr-2012-006562

30.

Papacostas MF, Hoge M, Baum M, Davila SZ (2016) Use of continuous renal replacement therapy in salicylate toxicity: a case report and review of the literature. Heart Lung 45(5):460–463CrossRefPubMed

31.

Tsai MF, Chen CY (2008) Valproate-induced hyperammonemic encephalopathy treated by hemodialysis. Ren Fail 30(8):822–824CrossRefPubMed

32.

Dharnidharka VR, Fennell RS, Richard GA (2002) Extracorporeal removal of toxic valproic acid levels in children. Pediatr Nephrol 17(5):312–315CrossRefPubMed

33.

Schurman SJ, Keeler V, Welch TR (2009) Massive gentamicin overdose in a 14-month-old. Pediatr Nephrol 24(1):211–213CrossRefPubMed

34.

Fuquay D, Koup J, Smith AL (1981) Management of neonatal gentamicin overdosage. J Pediatr 99(3):473–476CrossRefPubMed

35.

Hirsch DJ, Jindal KK, Wong P, Fraser AD (2001) A simple method to estimate the required dialysis time for cases of alcohol poisoning. Kidney Int 60(5):2021–2024CrossRefPubMed

36.

Kraut JA, Mullins ME (2018) Toxic alcohols. N Engl J Med 378(3):270–280CrossRefPubMed

37.

Roberts DM, Yates C, Megarbane B et al (2015) Recommendations for the role of extracorporeal treatments in the management of acute methanol poisoning: a systematic review and consensus statement. Crit Care Med 43(2):461–472CrossRefPubMed

38.

Ronco C, Bellomo R, Kellum JA, Ricci Z (2019) Critical care nephrology, 3rd edn. Elsevier

39.

Wiley JF (1999) Novel therapies for ethylene glycol intoxication. Curr Opin Pediatr 11(3):269–273CrossRefPubMed

40.

Kraut JA, Kurtz I (2008) Toxic alcohol ingestions: clinical features, diagnosis, and management. Clin J Am Soc Nephrol 3(1):208–225CrossRefPubMed

41.

Porter WH, Rutter PW, Bush BA, Pappas AA, Dunnington JE (2001) Ethylene glycol toxicity: the role of serum glycolic acid in hemodialysis. J Toxicol Clin Toxicol 39(6):607–615CrossRefPubMed

42.

Hewlett TP, McMartin KE, Lauro AJ, Ragan FA Jr (1986) Ethylene glycol poisoning. The value of glycolic acid determinations for diagnosis and treatment. J Toxicol Clin Toxicol 24(5):389–402CrossRefPubMed

43.

Shannon MW, Borron SW, Burns MJMD, Haddad LM, Winchester JF (2007) Haddad and Winchester’s clinical management of poisoning and drug overdose, 4th edn. Saunders Elsevier, Philadelphia, London

44.

Conklin L, Sejvar JJ, Kieszak S, Sabogal R, Sanchez C, Flanders D, Tulloch F, Victoria G, Rodriguez G, Sosa N, McGeehin MA, Schier JG (2014) Long-term renal and neurologic outcomes among survivors of diethylene glycol poisoning. JAMA Intern Med 174(6):912–917. https://doi.org/10.1001/jamainternmed.2014.344

45.

Litovitz T (1986) The alcohols: ethanol, methanol, isopropanol, ethylene glycol. Pediatr Clin N Am 33(2):311–323CrossRef

46.

Zakharov S, Pelclova D, Diblik P, Urban P, Kuthan P, Nurieva O, Kotikova K, Navratil T, Komarc M, Belacek J, Seidl Z, Vaneckova M, Hubacek JA, Bezdicek O, Klempir J, Yurchenko M, Ruzicka E, Miovsky M, Janikova B, Hovda KE (2015) Long term visual damage after acute methanol poisonings: longitudinal cross-sectional study in 50 patients. Clin Toxicol (Phila) 53(9):884–892. https://doi.org/10.3109/15563650.2015.1086488

47.

Peterová K, Brožová H, Klempíř J, Lišková I, Bezdicek O, Ridzoň P, Vaněčková M, Zakharov S, Pelclová D, Miovský M, Růžička E (2018) Gait and balance impairment after acute methanol poisoning. Basic Clin Pharmacol Toxicol 122(1):176–182. https://doi.org/10.1111/bcpt.12853

48.

Slaughter RJ, Mason RW, Beasley DM, Vale JA, Schep LJ (2014) Isopropanol poisoning. Clin Toxicol (Phila) 52(5):470–478CrossRef

49.

Church AS, Witting MD (1997) Laboratory testing in ethanol, methanol, ethylene glycol, and isopropanol toxicities. J Emerg Med 15(5):687–692CrossRefPubMed

50.

Rietjens SJ, de Lange DW, Meulenbelt J (2014) Ethylene glycol or methanol intoxication: which antidote should be used, fomepizole or ethanol? Neth J Med 72(2):73–79PubMed

51.

Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA (2002) American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol 40(4):415–446CrossRefPubMed

52.

Baird-Gunning J, Lea-Henry T, Hoegberg LCG, Gosselin S, Roberts DM (2017) Lithium poisoning. J Intensive Care Med 32(4):249–263CrossRefPubMed

53.

Rosen MS (2017) Lithium in child and adolescent bipolar disorder. Am J Psychiatry Residents J. https://doi.org/10.1176/appi.ajp-rj.2017.120202

54.

Bruns AS, Sebestyen J (2015) Twelve-year-old female with nausea, vomiting, edema, tremor, and slurred speech. Clin Pediatr (Phila) 54(2):194–196CrossRef

55.

McLean MM, Sherwin H, Madabhushi V, Tilney PV (2015) A 17-year-old female patient with a lithium overdose. Air Med J 34(4):162–165CrossRefPubMed

56.

Alsady M, Baumgarten R, Deen PM, de Groot T (2016) Lithium in the kidney: friend and foe? J Am Soc Nephrol 27(6):1587–1595. https://doi.org/10.1681/ASN.2015080907 CrossRefPubMed

57.

Adityanjee, Munshi KR, Thampy A (2005) The syndrome of irreversible lithium-effectuated neurotoxicity. Clin Neuropharmacol 28(1):38–49CrossRefPubMed

58.

Anani S, Goldhaber G, Wasserstrum Y, Dagan A, Segal G (2018) The “62 SILENT alarm”: when history taking reveals a potentially fatal toxicity. Eur J Case Rep Intern Med 5(6):000843. https://doi.org/10.12890/2018_000843 CrossRefPubMedPubMedCentral

59.

Decker BS, Goldfarb DS, Dargan PI et al (2015) Extracorporeal treatment for lithium poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin J Am Soc Nephrol 10(5):875–887CrossRefPubMedPubMedCentral

60.

Schmidt JJ, Lorenzen J, Chatzikyrkou C, Lichtinghagen R, Kielstein JT (2014) Total collected dialysate lithium concentration after successful dialysis treatment in case of intoxication. BMC Pharmacol Toxicol 15:49CrossRefPubMedPubMedCentral

61.

Haussmann R, Bauer M, von Bonin S, Grof P, Lewitzka U (2015) Treatment of lithium intoxication: facing the need for evidence. Int J Bipolar Disord 3:23. https://doi.org/10.1186/s40345-015-0040-2 CrossRefPubMedPubMedCentral

62.

McKamy S, Hernandez E, Jahng M, Moriwaki T, Deveikis A, Le J (2011) Incidence and risk factors influencing the development of vancomycin nephrotoxicity in children. J Pediatr 158(3):422–426CrossRefPubMed

63.

Rybak MJ (2006) The pharmacokinetic and pharmacodynamic properties of vancomycin. Clin Infect Dis 42(S1):S35–S39CrossRefPubMed

64.

Vancomycin injections US prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/060180s047lbl.pdf Accessed on 20 February 2019

65.

Bunchman TE, Valentini RP, Gardner J, Mottes T, Kudelka T, Maxvold NJ (1999) Treatment of vancomycin overdose using high-efficiency dialysis membranes. Pediatr Nephrol 13(9):773–774CrossRefPubMed

66.

Lemaire M, Connolly B, Harvey E, Licht C (2010) Treatment of paediatric vancomycin intoxication: a case report and review of the literature. NDT Plus 3(3):260–264PubMedPubMedCentral

67.

Bronstein AC, Spyker DA, Cantilena LR, Green J, Rumack BH, Heard SE (2007) 2006 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS). Clin Toxicol (Phila) 45(8):815–917CrossRef

68.

Ma YJ, Jiang DQ, Meng JX et al (2016) Theophylline: a review of population pharmacokinetic analyses. J Clin Pharm Ther 41(6):594–601CrossRefPubMed

69.

Ghannoum M, Wiegand TJ, Liu KD et al (2015) Extracorporeal treatment for 92 theophylline poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 53(4):215–229CrossRef

70.

Theophylline in dextrose injections USPI. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/019211s042lbl.pdf accessed 19 February 2019.

71.

Laussen P, Shann F, Butt W, Tibballs J (1991) Use of plasmapheresis in acute theophylline toxicity. Crit Care Med 19:288–290CrossRefPubMed

72.

Mactier R, Laliberte M, Mardini J, Ghannoum M, Lavergne V, Gosselin S, Hoffman RS, Nolin TD; EXTRIP Workgroup (2014) Extracorporeal treatment for barbiturate poisoning: recommendations from the EXTRIP workgroup. Am J Kidney Dis 64(3):347–358

73.

Mihic S, Harris R (2011) Hypnotics and sedatives. In: Brunton LL, Chabner BA, Knollmann BC (eds) Goodman & Gilman’s the pharmacological basis of therapeutics, 12th edn. McGraw-Hill, New York, pp 457–480

74.

Hoyland K, Hoy M, Austin R et al (2013) Successful use of haemodialysis to treat phenobarbital overdose. BMJ Case Rep 21;2013:cr2013010011. https://doi.org/10.1136/bcr-2013-010011 CrossRef

75.

Metformin tablet US prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/020357s037s039,021202s021s023lbl.pdf Accessed 20 February 2019

76.

Calello DP, Liu KD, Wiegand TJ Roberts DM, Lavergne V, Gosselin S, Hoffman RS, Nolin TD, Ghannoum M; Extracorporeal Treatments in Poisoning Workgroup (2015) Extracorporeal treatment for metformin poisoning: systematic review and recommendations from the extracorporeal treatments in poisoning workgroup. Crit Care Med 43(8):1716–1730

77.

Luft D, Deichsel G, Schmülling RM et al (1983) Definition of clinically relevant lactic acidosis in patients with internal diseases. Am J Clin Pathol 80:484–489CrossRefPubMed

78.

Mirrakhimov AE, Barbaryan A, Gray A, Ayach T (2016) The role of renal replacement therapy in the management of pharmacologic poisonings. Int J Nephrol. https://doi.org/10.1155/2016/3047329

79.

Regolisti G et al (2017) Treatment of metformin intoxication complicated by lactic acidosis and acute kidney injury: the role of prolonged intermittent hemodialysis. Am J Kidney Dis Aug 70(2):290–296CrossRef

80.

Leonaviciute D, Madsen B, Schmedes A, Buus NH, Rasmussen BS (2018) Severe metformin poisoning successfully treated with simultaneous venovenous hemofiltration and prolonged intermittent hemodialysis. Case Reps Crit Care. https://doi.org/10.1155/2018/3868051

81.

Carbamazepine US prescribing information. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7a1e523a-b377-43dc-b231-7591c4c888ea. Accessed 21 February 2019.

82.

Goldfrank LR, Flomenbaum N (2006) Goldfrank’s toxicologic emergencies, 8th edn. McGraw-Hill Medical Pub. Division, New York

83.

Ozhasenekler A, Gokhan Ş, Guloglu C, Orak M, Ustundag M (2012) Benefit of hemodialysis in carbamazepine intoxications with neurological complications. Eur Rev Med Pharmacol Sci 16(Suppl 1):43–47PubMed

84.

Ghannoum M, Yates C, Galvao TF, Sowinski KM, Vo TH, Coogan A, Gosselin S, Lavergne V, Nolin TD, Hoffman RS, EXTRIP workgroup (2014) Extracorporeal treatment for carbamazepine poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 52(10):993–1004CrossRef

85.

Howard SC, McCormick J, Pui CH, Buddington RK, Harvey RD (2016) Preventing and managing toxicities of high-dose methotrexate. Oncologist 21(12):1471–1482CrossRefPubMedPubMedCentral

86.

Methotrexate US prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/008085s066lbl.pdf. Accessed 23 February 2019

87.

Widemann BC, Balis FM, Murphy RF et al (1997) Carboxypeptidase-G2, thymidine, and leucovorin rescue in cancer patients with methotrexate-induced renal dysfunction. J Clin Oncol 15(5):2125–2134CrossRefPubMed

88.

Anseeuw K, Mowry JB, Burdmann EA et al (2016) Extracorporeal treatment in phenytoin poisoning: systematic review and recommendations from the EXTRIP (Extracorporeal Treatments in Poisoning) workgroup. Am J Kidney Dis 67(2):187–197CrossRefPubMed

89.

Olyaei AJ, Bennett WM (2008) Drug dosage in renal failure. In: De Broe ME, Porter GA (eds) Clinical nephrotoxins, renal injury from drugs and chemicals, 3rd edn. Springer, US

90.

Acetaminophen US prescribing information https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/204767s000lbl.pdf Accessed 26 February 2019.

91.

Ogilvie JD, Rieder MJ, Lim R (2012) Acetaminophen overdose in children. CMAJ 184(13):1492–1496CrossRefPubMedPubMedCentral

92.

Marzullo L (2005) An update of N-acetylcysteine treatment for acute acetaminophen toxicity in children. Curr Opin Pediatr 17(2):239–245CrossRefPubMed

93.

Gosselin S, Juurlink DN, Kielstein J et al (2014) Extracorporeal treatment for acetaminophen poisoning: recommendations from the EXTRIP workgroup. Clin Toxicol 52(8):856–867CrossRef

94.

Aspirin US prescribing information. https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/200671s000lbl.pdf Accessed on 28 February 2019

95.

Dargan PI, Wallace CI, Jones AL (2002) An evidence-based flowchart to guide the management of acute salicylate (aspirin) overdose. Emerg Med J 19(3):206–209CrossRefPubMedPubMedCentral

96.

Juurlink DN, Gosselin S, Kielstein JT, Ghannoum M, Lavergne V, Nolin TD, Hoffman RS, EXTRIP Workgroup (2015) Extracorporeal treatment for salicylate poisoning: systematic review and recommendations from the EXTRIP workgroup. Ann Emerg Med 266(2):165–181CrossRef

97.

Ghannoum M, Laliberte M, Nolin TD et al (2015) Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 53(5):454–465CrossRef

98.

Thanacoody RH (2009) Extracorporeal elimination in acute valproic acid poisoning. Clin Toxicol (Phila) 47(7):609–616CrossRef

99.

Knorr M, Schaper J, Harjes M, Mayatepek E, Rosenbaum T (2004) Fanconi syndrome caused by antiepileptic therapy with valproic acid. Epilepsia 45(7):868–871CrossRefPubMed

100.

Hanley P, Cunningham RJ, Lou L, Vog B, Raina R (2015) Muscle weakness and pain with profound hypophosphatemia: mystery revealed. Clin Pediatr (Phila) 54(10):1012–1013. https://doi.org/10.1177/0009922815590225 CrossRef

101.

Hicks LK, McFarlane PA (2001) Valproic acid overdose and haemodialysis. Nephrol Dial Transplant 16(7):1483–1486CrossRefPubMed

102.

Singh J, Burr B, Stringham D, Arrieta A (2001) Commonly used antibacterial and antifungal agents for hospitalised paediatric patients: implications for therapy with an emphasis on clinical pharmacokinetics. Paediatr Drugs 3(10):733–761CrossRefPubMed

Title: Renal replacement therapy in the management of intoxications in children: recommendations from the Pediatric Continuous Renal Replacement Therapy (PCRRT) workgroup
Authors: Rupesh Raina
Manpreet K Grewal
Martha Blackford
Jordan M. Symons
Michael J. G. Somers
Christoph Licht
Rajit K Basu
Sidharth Kumar Sethi
Deepa Chand
Gaurav Kapur
Mignon McCulloch
Arvind Bagga
Vinod Krishnappa
Hui-Kim Yap
Marcelo de Sousa Tavares
Timothy E Bunchman
Michelle Bestic
Bradley A Warady
Maria Díaz-González de Ferris
Publication date: 01-11-2019
Publisher: Springer Berlin Heidelberg
Keywords: Paracetamol
Aminoglycoside
Intoxication
Metformin
Methotrexate
Methotrexate
Vancomycin
Theophylline
Carbamazepine
Phenytoin
Valproate
Barbiturate
Published in: Pediatric Nephrology / Issue 11/2019
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-019-04319-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Renal replacement therapy in the management of intoxications in children: recommendations from the Pediatric Continuous Renal Replacement Therapy (PCRRT) workgroup

Abstract

Background

Methods

Results and Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results and Conclusions

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