@article{ref1,
title="Baclofen self-poisoning: is renal replacement therapy efficient in patient with normal kidney function?",
journal="Anaesthesia, critical care and pain medicine",
year="2020",
author="Brunet, Marion and Léger, Maxime and Billat, Pierre-André and Lelièvre, Bénédicte and Lerolle, Nicolas and Boels, David and Le Roux, Gaël",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="AIMS: We aimed at assessing the effectiveness of renal replacement therapy in patients severely self-poisoned with baclofen and with normal kidney function.  METHODS: A population pharmacokinetic model was built using analytical data extracted from 26 baclofen poisoning cases reported to a French Poison Centre: 8 patients underwent renal replacement therapy (RRT), 18 did not. In the RRT group, 2 patients suffered from kidney failure. Mechanical ventilation was required for 20 patients with normal kidney function; 15 were not treated by RRT and 5 were. Pharmacokinetic profiles of baclofen were measured in 28 patients and further modelled by a non-parametric approach (PMetrics®). The total data set was divided into a building data set (26 patients, 57 observations) and a validation set (2 external patients, 6 observations). Then, the estimated elimination half-life of baclofen and the duration of intubation were compared in patients with or without RRT using Wilcoxon-Mann-Whitney test.  RESULTS: A model using three parameters plus a lag time and bioavailability was necessary to determine the pharmacokinetics of baclofen. Estimated elimination half-life in the 'RRT' group and the 'no RRT' group were respectively 3.1 [2.2-4.8] h (n = 6 patients) and 3.4 [1.4-5.5] h (n = 19 patients, p = 0.53). The median duration of intubation was not significantly different between groups (72 [48-72] h and 72 [24-96] h, respectively; p = 0.38).  CONCLUSION: Renal replacement therapy did not appear to significantly increase baclofen clearance in patients without kidney failure.<p /> <p>Language: en</p>",
language="en",
issn="2352-5568",
doi="10.1016/j.accpm.2020.07.021",
url="http://dx.doi.org/10.1016/j.accpm.2020.07.021"
}