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Treatment of digitalis intoxication by charcoal hemoperfusion (CHP)
Insights
Activated charcoal hemoperfusion effectively removes digoxin in vitro and in vivo. This method offers rapid digoxin removal for treating intoxication, showing promising results where other treatments have failed.
Area of Science:
- Toxicology
- Nephrology
- Cardiology
Background:
- Digoxin intoxication poses a significant clinical challenge.
- Existing treatment modalities for digoxin toxicity have limited success rates.
Purpose of the Study:
- To evaluate the efficacy of activated charcoal hemoperfusion for digoxin removal.
- To assess both in vitro and in vivo performance of hemoperfusion in digoxin-intoxicated subjects.
Main Methods:
- Hemoperfusion utilizing activated charcoal was employed for drug removal.
- In vitro experiments measured drug clearance at specific blood flow rates.
- In vivo studies were conducted on digoxin-intoxicated dogs to determine clearance rates.
Main Results:
- In vitro, digoxin removal reached 33 ml/min at 160 ml/min blood flow, with 83% removed in 2.5 hours.
- In vivo, hemoperfusion achieved a clearance rate of 55 ml/min at 150 ml/min blood flow in dogs.
- Significant digoxin reduction was observed in both experimental settings.
Conclusions:
- Activated charcoal hemoperfusion demonstrates efficient digoxin removal capabilities.
- This technique presents a potentially effective strategy for rapid management of digoxin intoxication.
- Hemoperfusion offers a promising alternative for severe cases unresponsive to conventional therapies.
Abstract:
In the present communication, we demonstrate the removal of digoxin both in vitro and in vivo from digoxin intoxicated dogs by use of hemoperfusion over activated charcoal. In vitro drug removal was 33 ml/min at mean blood flow rates of 160 ml/min. By 30 mins of in vitro perfusion 51% of drug was removed from the reservoir and by 2 1/2 hrs 83%. In vivo clearance in dogs was 55 ml/min at blood flow rates of 150 ml/min. In view of the poor success that has been encountered in the treatment of digoxin intoxication with other modalities, charcoal hemoperfusion may represent an effective method of rapid digoxin removal from blood.