Assessment of barbiturate removal by charcoal hemoperfusion in overdose cases

Five patients with severe barbiturate intoxication were treated with charcoal hemoperfusion. The perfusions were carried out for 3.5 hr, two of the patients requiring an additional treatment. A marked clinical improvement was observed in all of the patients. The serum concentration decreased by 17 to 42% and the amount removed corresponded to 4 to 13% of the ingested dose. The clearance decreased from the start to the end of the treatment during most of the perfusions. With phenobarbital the clearance was less reduced and the column still had the capacity to adsorb drugs after the 3.5-hr perfusion. Therefore, since the amount of drug removed was relatively small, longer lasting perfusions are recommended.