Experience with cellulose acetate-coated activated charcoal haemoperfusion in the treatment of severe hypnotic drug intoxication

Abstract

A haemoperfusion column containing activated charcoal coated with cellulose acetate was used to treat 7 patients with barbiturate or ethchlorvynol poisoning. Six of the patients showed marked lightening of coma and all showed a significant fall in plasma drug concentration. Plasma drug clearance and platelet loss were similar to those reported for other coated charcoal columns. Cellulose acetate-coated charcoal haemoperfusion may reduce the period of coma in severe poisoning with barbiturates and other hypnotic drugs and thus the morbidity and mortality.

Evaluation of Intoxication Cases Followed up in Pediatric Intensive Care Unit During COVID-19 Pandemic with Social Restrictions

“…Charcoal efficiently removes molecules between the range of 1,000-1,500 kDa and has a great affinity for water-soluble molecules, whereas resins have a higher affinity for lipid-soluble molecules. Uremic metabolites, toxic substances, and creatinine easily pass through the membrane and are adsorbed from the plasma (12). In this method, blood is perfused through the Adsorba 150 and 300 (Gambro Inc., Hechingen, Germany) cartridge of charcoal granules.…”

“…In this method, blood is perfused through the Adsorba 150 and 300 (Gambro Inc., Hechingen, Germany) cartridge of charcoal granules. It is proven that these cartridges efficiently absorb the following drugs; barbiturates, organophosphates, bromocarbamide, paracetamol, ethchlorvynol, paraquat, meprobamate, phenacetin, methaqualone, and salicylate (12). In this study, hemoperfusion was performed at least for six hours according to the clinician's discretion.…”

Extracorporeal Treatment in Phenytoin Poisoning: Systematic Review and Recommendations from the EXTRIP (Extracorporeal Treatments in Poisoning) Workgroup

“…Rationale: According to the workgroup, intermittent HD is the preferred modality of ECTR in phenytoin poisoning. This recommendation is supported by the following arguments: clearance of phenytoin has increased dramatically with the use of high-flux synthetic membranes compared to less efficient cuprophane or polyacrylonitrile filters; 103 intermittent HD is the most widely available modality of dialysis worldwide; more physicians and nurses are experienced with HD, with lesser risks of delay and uncertainty; the complication rate with HD appears favorable in comparison to HP, especially with regard to thrombocytopenia during HP, as described in some of the patients included in the cohort; 18,73,88 the cost of HD favors it over HP. This is largely explained by the cost of monitoring and treating complications as well as the lower cost of dialysis filters versus charcoal cartridges, which need to be replaced regularly because of saturation of their adsorptive capacity.…”

Experience with activated carbon-bead haemoperfusion columns in the treatment of severe drug intoxication

“…Our experience in the clinical use of various charcoal haemoperfusion devices based on coconut-shell charcoal has been reported previously (Vale et al 1975a, b;Hampel et al 1980;Crome et al 1980). A recent development has been the introduction of petroleum-based activated carbon beads which are extremely hard and very resistant to mechanical abrasion (Nakashima and Takakura 1977).…”