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Continuous arteriovenous hemoperfusion in acute poisoning
1Division of Nephrology and Poison Center, Chang Gung Memorial Hospital, Chang Gung Medical College, Lin-Kou Medical Center, Taipei, Taiwan, ROC.
Blood Purification
|January 1, 1994
Summary
Continuous arteriovenous hemoperfusion (CAVHP) effectively treated acute intoxications. This pumpless technique demonstrated high solute elimination and improved patient hemodynamics, offering a safe and cost-effective alternative.
Area of Science:
- Toxicology
- Nephrology
- Critical Care Medicine
Background:
- Acute intoxication cases require effective and rapid removal of toxic substances from the blood.
- Conventional hemoperfusion techniques often rely on external pumps, which can be complex and costly.
- Continuous arteriovenous hemoperfusion (CAVHP) is a pumpless extracorporeal technique for blood purification.
Observation:
- Three patients with acute intoxication (meprobamate, theophylline, phenobarbital) were treated using CAVHP.
- Patients included those who were hemodynamically unstable and comatose.
- CAVHP achieved significant blood flow (120 cm3/min) even in severe hypotension, increasing to 150-400 cm3/min with blood pressure restoration.
Findings:
- CAVHP demonstrated dramatic clinical responses in intoxicated patients.
- High solute elimination was achieved, with hemoperfusion clearances for meprobamate, phenobarbital, and theophylline measured at 198 +/- 5.6 cm3/min, 290.25 +/- 25.33 cm3/min, and 192.79 +/- 55 cm3/min, respectively.
- The technique was effective in improving hemodynamic stability and patient consciousness.
Implications:
- CAVHP presents a simple, safe, and effective alternative to conventional hemoperfusion for acute intoxications.
- The pumpless nature of CAVHP may reduce complexity and cost associated with extracorporeal treatments.
- Further research into CAVHP's application in various intoxication scenarios is warranted.