Severe poisoning with intravenous phenytoin in the newborn. Value of peritoneal dialysis

: A severe poisoning with intravenous phenytoin in a newborn was treated with peritoneal dialysis in spite of its reported poor effectiveness, the drug being 90% protein-bound. During 10 hours, 1.41 mg/hr were eliminated by biotransformation and 1.80 mg/hr were removed with peritoneal dialysis allowing to suppress quickly life threatening cardiac side effects. This efficacy may be explained by an increase in the unbound protein fraction and a diffusion speed through the peritoneum higher than in older patients.