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Removal of toxic substances by a selective membrane plasma separator
Hajime Nakae1, Tomoko Hattori, Toshiko Igarashi
1Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine, Akita, Japan.
Summary
Plasma exchange with dialysis (PED) effectively removes phenobarbital and lithium, comparable to direct hemoperfusion and selective plasma exchange. This blood purification therapy shows promise for treating drug poisoning.
Area of Science:
- Nephrology
- Toxicology
- Biomedical Engineering
Background:
- Selective plasma exchange (sPE) using EC-2A was useful for acute liver failure.
- A new device, EC-4A with a higher albumin-sieving coefficient, was developed for enhanced removal of protein-bound substances.
Purpose of the Study:
- To evaluate the efficacy of plasma exchange with dialysis (PED) using EC-4A for drug poisoning treatment.
- To compare PED with sPE and direct hemoperfusion (DHP) for removing phenobarbital and lithium.
Main Methods:
- Extracorporeal circulation study comparing sPE, PED, and DHP.
- Measurement of phenobarbital and lithium blood concentrations over 180 minutes.
Main Results:
- PED significantly decreased phenobarbital levels compared to sPE and was comparable to DHP.
- PED significantly decreased lithium levels compared to DHP and was comparable to sPE.
Conclusions:
- PED using EC-4A is as effective as DHP for phenobarbital removal.
- PED using EC-4A is as effective as sPE for lithium removal.
- PED therapy with EC-4A is a potential treatment for drug poisoning.
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