Continuous venovenous hemodiafiltration to treat controlled-release carbamazepine overdose in a pediatric patient

Carbamazepine (CBZ) intoxication is an important issue in acute poisoning practice. Highly protein-bound, CBZ is not removed efficiently through conventional hemodialysis. We describe the use of continuous venovenous hemodiafiltration (CVVHDF) in a 2-year-old boy who developed general tonic clonic seizure and respiratory depression due to controlled-release formula of CBZ overdose (peak drug level of >20 μg·ml⁻¹, therapeutic range: 5–10 μg·ml⁻¹). Serum CBZ concentrations fell to 0.25 μg·ml⁻¹ at the end of hemodiafiltration. The patient recovered rapidly and was discharged from hospital 4 days from the time of ingestion with no complications or neurologic impairment.