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Dialysis

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Eva Baroke, Julius J Schmidt, Ann-Kathrin Strunk

Clinical Nephrology

|January 21, 2015

Summary

High cut-off hemodialysis effectively treated a severe diphenhydramine (DPH) overdose, enabling rapid patient recovery and the discovery of another victim. This method offers a viable alternative for managing specific poisonings.

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Area of Science:

Toxicology
Nephrology
Emergency Medicine

Background:

Hemodialysis is standard for intoxications, but less effective for protein-bound toxins.
Charcoal hemoperfusion is an alternative but has limitations like availability and side effects.
Diphenhydramine (DPH) overdose can cause severe central nervous system depression.

Observation:

A patient presented with stupor due to a life-threatening diphenhydramine overdose.
High cut-off hemodialysis was initiated as an emergency treatment.
The patient's neurological status rapidly improved following the procedure.

Findings:

High cut-off hemodialysis successfully removed diphenhydramine from the patient's system.
Rapid detoxification led to a swift return of consciousness.
The patient was able to communicate critical information about another poisoning victim.

Implications:

High cut-off hemodialysis is a potentially life-saving intervention for severe diphenhydramine overdose.
This technique may be effective for other highly protein-bound intoxicants.
Prompt treatment facilitated not only patient survival but also the rescue of another individual.