Hemoperfusion in Drug Overdose

Gelfand, Michael

doi:10.1001/jama.1978.03290250065037

Cited by 7 publications

(1 citation statement)

References 7 publications

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“…They reported a haemodialysis clearance of 60 mL min-' for phenobarbitone at a flow rate of 200 mL min-I, while an average clearance of 72 mL min-' was reported from the charcoal haemoperfusion columns. Gelfand (1978) reported on the clinical use of haemoperfusion and haemodialysis in the treatment of drug overdose. Using haemoperfusion for the treatment of phenobarbitone overdose in a 42-year-old female patient, a mean clearance value of 50 mL min-I was reported at a 100 mL min-' blood flow rate.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Sorbent Suspension Reciprocating Dialyser in the Treatment of Overdose of Paracetamol and Phenobarbitone

Shihab-Eldeen

Peck

Ash

et al. 1988

Journal of Pharmacy and Pharmacology

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Poisoning with paracetamol (acetaminophen) and phenobarbitone is a common occurrence in the United States and Europe. The removal efficiency of these drugs by a sorbent suspension reciprocating dialyser (SSRD) has been investigated. The SSRD is a parallel plate dialyser with a reciprocating blood flow and free mobile sorbent suspension composed of charcoal and zeolites. This arrangement provided a system with minimal sorbent saturation. High performance liquid chromatography was used for the quantification of the drugs in aqueous and serum fluids. The in-vitro removal efficiency of the dialyser was studied by dialysing a large volume of the drug in solution for 12 to 16 h. The removal efficiency remained relatively constant up to 10 h of dialysis. The in-vivo dialysis studies were performed using normal dogs. Large doses of the drugs were administered orally or intravenously to achieve high blood levels. The clearance values obtained from these studies were comparable with, or in excess of, the values reported in the literature for conventional dialysers. The major advantage of the SSRD is the ability of the unit to be used for prolonged dialysis and to provide a system with minimal sorbent saturation due to mixing and interchange of sorbent granules next to the membrane surface.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Sorbent Suspension Reciprocating Dialyser in the Treatment of Overdose of Paracetamol and Phenobarbitone

Shihab-Eldeen

Peck

Ash

et al. 1988

Journal of Pharmacy and Pharmacology

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Extracorporeal Treatment of Poisonings

Abramson¹

2010

Chronic Kidney Disease, Dialysis, and Transplantation

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Resin hemoperfusion in dogs intoxicated with ethchlorvynol (Placidyl®)

Zmuda¹

1980

Kidney International

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Kinetic parameters were studied to determine the effectiveness of hemoperfusion in removing ethychlorvynol from the plasma and red blood cells (RBC) of intoxicated dogs. Perfusion columns contained polystyrene/divinyl benzene resin (XAD-4 Amberlite. Column clearances of ethchlorvynol averaged 96.5 +/- 0.4% of the plasma flow rate (mean +/- SEM, 9 dogs). Plasma ethchlorvynol t 1/2's during preperfusion periods averaged 94.1 hr. During hemoperfusion, t 1/2's averaged 3.8 hr, or 90.3 hr shorter than at the endogenous rate of detoxication. There was no significant difference between preperfusion and postperfusion half lives. An estimate based on plasma column clearance suggests that 1.5 +/- 0.1 g ethchlorvynol, or 19.0 +/- 2.8% of the dose, was removed by hemoperfusion. The amount eluted from the resin was 2.9 +/- 0.3 g (37.2 +/- 5.8% of the dose), or about twice the amount apparent from plasma clearance alone. Further, the volume of distribution of ethchlorvynol was 2.3 +/- 0.2 liters/kg, suggesting significant distribution to intracellular and extravascular compartments. The results show that resin hemoperfusion removes a large fraction of ethchlorvynol from intoxicated dogs, and greatly adds to endogenous mechanisms for elimination. Ethchlorvynol was removed from RBC directly, and ultimately from extravascular sites as well.

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Hemoperfusion in Drug Overdose

Cited by 7 publications

References 7 publications

Evaluation of the Sorbent Suspension Reciprocating Dialyser in the Treatment of Overdose of Paracetamol and Phenobarbitone

Evaluation of the Sorbent Suspension Reciprocating Dialyser in the Treatment of Overdose of Paracetamol and Phenobarbitone

Extracorporeal Treatment of Poisonings

Resin hemoperfusion in dogs intoxicated with ethchlorvynol (Placidyl®)

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