@article{ref1,
title="[Deep lactic acidosis after valproate self-poisoning]",
journal="Annales Francaises d'Anesthesie et de Reanimation",
year="2004",
author="Blayac, D. and Roch, A. and Michelet, P. and De Francheschi, E. and Auffray, J.-p.",
volume="23",
number="10",
pages="1007-1010",
abstract="A sixty-year-old woman was admitted in the ICU after Depamide (Valpromide) self-poisoning (430 mg/kg). Four hours after the ingestion, the patient presented coma (Glagow coma score of 3) with bilateral mydriasis requiring tracheal intubation and mechanical ventilation, hypotension requiring epinephrine infusion (0.9 microg/kg per minute), acidosis and hyperlactatemia (29.7 mmol/l at 12 hours) without any kidney or liver failure. The maximal serum valproic acid concentration measured was 342 mg/l after twelve hours (therapeutic rate: 35-85 mg/l). A continuous infusion of sodium bicarbonate was associated with continuous venovenous haemodiafiltration. Progressive haemodynamic improvement and neurologic recovery leaded to extubation at 36 hours.<p /><p>Language: fr</p>",
language="fr",
issn="0750-7658",
doi="10.1016/j.annfar.2004.07.006",
url="http://dx.doi.org/10.1016/j.annfar.2004.07.006"
}