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Hemoperfusion in diabetic coma.

C Giordano, R Esposito, P Bello

    Contributions to Nephrology
    |January 1, 1982
    PubMed
    Summary
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    Diabetic keto-acidosis (DKA) coma can be treated with hemoperfusion using ionic exchange resins. This method effectively removes ketoanions and organic acids while providing smooth bicarbonate administration, avoiding side effects.

    Area of Science:

    • Nephrology
    • Biomedical engineering
    • Metabolic disorders

    Background:

    • Diabetic keto-acidosis (DKA) coma presents significant therapeutic challenges.
    • Current intravenous bicarbonate therapy for DKA coma can lead to adverse side effects.
    • Ionic exchange resins offer a potential alternative for managing DKA coma.

    Purpose of the Study:

    • To evaluate the efficacy of hemoperfusion using ionic exchange resins for DKA coma treatment.
    • To assess the resin's ability to release bicarbonates and remove ketoanions.
    • To determine if this method avoids side effects associated with conventional therapy.

    Main Methods:

    • Hemoperfusion trials were conducted using strong anionic resins in a mixed form (bicarbonate and chloride).
    • Open-circuit trials identified optimal resin mixtures and release/trapping capacities.

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  • Ten simulated closed-circuit hemoperfusions utilized cartridges with 1,700g of mixed resin (9% bicarbonate, 91% chloride form).

    • Main Results:

    • The hemoperfusion method provided smooth bicarbonate administration, avoiding side effects of intravenous therapy.
    • Effective removal of ketoanions and organic acids was achieved.
    • Blood osmolality remained stable during the simulated hemoperfusions.

    Conclusions:

    • Hemoperfusion with ionic exchange resins is a promising therapeutic approach for DKA coma.
    • This method offers a safer alternative to intravenous bicarbonate therapy by mitigating side effects.
    • The resin system efficiently manages acid-base balance and toxin removal in DKA coma.