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[Detoxication by hemoperfusion]

G Stein, U Demme, H Sperschneider

    Zeitschrift Fur Die Gesamte Innere Medizin Und Ihre Grenzgebiete
    |December 15, 1981
    PubMed
    Summary
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    Haemoperfusion using Amberlite XAD-4 resin effectively removed toxic substances from patients with severe overdoses. This detoxification method proved more efficient than dialysis in clearing blood concentrations of various drugs.

    Area of Science:

    • Toxicology
    • Nephrology
    • Pharmacology

    Context:

    • Severe intoxications involving hypnotics, sedatives, psychopharmaca, propranolol, and halogenated hydrocarbons present significant clinical challenges.
    • Traditional treatments like dialysis may have limitations in effectively clearing a wide range of toxic substances.
    • Amberlite XAD-4 resin hemoperfusion offers a potential alternative for enhanced drug removal.

    Purpose:

    • To evaluate the efficacy of 4–8-hour hemoperfusion with Amberlite XAD-4 resin in treating patients with severe drug intoxications.
    • To assess the blood concentration reduction of specific toxic agents following hemoperfusion.
    • To compare the effectiveness of hemoperfusion with dialysis for detoxification.

    Summary:

    • Thirteen patients with severe intoxications underwent hemoperfusion with Amberlite XAD-4 resin.

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  • Eleven patients survived, with two deaths attributed to intoxication sequelae.
  • Hemoperfusion demonstrated good elimination of phenobarbital, crotylbarbital, methaqualone, meprobamate, didropyridine, and trichlorethylene, with less efficient removal of nitrazepam, propranolol, and tetrachloroethylene. Overall detoxification was more effective per unit time compared to dialysis.

    • Impact:

    • Hemoperfusion with Amberlite XAD-4 resin is a viable and effective treatment for severe drug intoxications.
    • This method offers a time-efficient detoxification strategy compared to hemodialysis.
    • The study highlights the importance of resin hemoperfusion in managing complex poisoning cases.