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[Hemoperfusion therapy in severe suicidal digoxin poisoning].

H Achenbach, D Sorger, C Wesslau

    Zeitschrift Fur Die Gesamte Innere Medizin Und Ihre Grenzgebiete
    |March 1, 1984
    PubMed
    Summary

    Hemoperfusion effectively manages severe digoxin toxicity by improving clinical symptoms and cardiac rhythm disturbances. Early intervention with hemoperfusion leads to better patient outcomes in digoxin poisoning cases.

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    Area of Science:

    • Pharmacology
    • Toxicology
    • Cardiology

    Context:

    • Severe digoxin intoxication presents a significant mortality risk (approx. 20%).
    • Management of life-threatening digoxin overdose requires effective interventions.
    • Suicidal ingestion of digoxin necessitates prompt and aggressive treatment.

    Purpose:

    • To evaluate the efficacy of hemoperfusion in treating severe digoxin intoxication.
    • To assess the impact of hemoperfusion on clinical course, ECG changes, and plasma digoxin levels.
    • To determine the optimal timing for initiating hemoperfusion in digoxin poisoning.

    Summary:

    • Hemoperfusion was performed on 3 out of 4 patients with severe digoxin intoxication due to suicidal overdose.
    • Patients undergoing hemoperfusion showed significant improvement in clinical symptoms and cardiac arrhythmias.

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  • Earlier initiation of hemoperfusion correlated with more favorable clinical outcomes.
  • A non-perfused patient experienced a prolonged and severe clinical and ECG course.
  • The removed free digoxin fraction, though small, demonstrated significant pharmacological and clinical importance.
  • The adsorber material exhibited consistent high clearance, and hemoperfusion was well-tolerated without complications.

    • Impact:

    • Hemoperfusion is a viable and safe treatment option for severe digoxin toxicity.
    • Early hemoperfusion can mitigate the severity and duration of digoxin intoxication.
    • This study highlights the clinical significance of free digoxin in toxicity management.
    • Findings support the integration of hemoperfusion into treatment protocols for digoxin overdose.