Extracorporeal elimination of carbamazepine by haemoperfusion

The clearance of the haemoperfusion cartridge H 200 C Tekin was determined in vitro for blood dissolved carbamazepine to test the efficiency of haemoperfusion treatment. In the first hour of in vitro haemoperfusion test of pig blood (concentration of carbamazepine 1084 mg/l) a clearance of 190 ml/min was obtained, which declined slightly to 150 ml/min after 4 hours. In a second test the elimination of carbamazepine from albumin solution was proven to be more than 1000 mg of carbamazepine after a four hour perfusion period using teflon coated charcoal. These results are in accordance with the clinical course of a 30 years old male patient who presented with severe hypoxaemia due to acute intoxication by 6 g carbamazepine. The carbamazepine blood level was 33.7 mg/l. Charcoal haemoperfusion was started immediately. A dramatic improvement of clinical symptoms was already observed during haemoperfusion. The carbamazepine serum level was 18.6 mg/l after 4 hours of haemoperfusion.