Therapeutic Effectiveness of Sustained Low‐Efficiency Hemodialysis Plus Hemoperfusion and Continuous Hemofiltration Plus Hemoperfusion for Acute Severe Organophosphate Poisoning

Abstract

There is no report on the effects of sustained low-efficiency dialysis (SLED) plus hemoperfusion (HP) (SLED + HP) in patients with acute severe organophosphate (OP) poisoning (ASOPP). This study was designed to compare the therapeutic effectiveness between SLED + HP and continuous hemofiltration (CHF) plus HP (CHF + HP) in patients with ASOPP. In order to assess the two treatment methods, 56 patients with ASOPP were divided into CHF + HP group and SLED + HP group. The biochemical indicators, in-hospital duration, hemodynamic parameters, Acute Physiology, and Chronic Health Evaluation (APACHE II) score, and survival and mortality rates were compared. In both groups after treatment, the levels of serum creatine kinase isozyme MB, creatine kinase, creatinine, glutamic-oxalacetic transaminease, and glutamate-pyruvate transaminase, and the APACHE II scores on the first, second, and seventh day decreased (P < 0.05), whereas the levels of serum acetylcholinesterase increased. The two groups showed no statistical differences in in-hospital duration, biochemical indicators, APACHE II score, hemodynamic parameters, survival rate, or the mortality rate (P > 0.05). In conclusion, SLED has similar hemodynamic stability to CHF and the two treatment methods have similar effects on ASOPP patients. More importantly, SLED plus HP is relatively economical and convenient for patients with ASOPP in clinical practice.

Clinical analysis of penehyclidine hydrochloride combined with hemoperfusion in the treatment of acute severe organophosphorus pesticide poisoning

“…Otherwise, the optimal treatment time will be delayed. Although hemoperfusion treatment has a curative effect, it only removes the poison, but it does not correct the pathophysiological changes caused by the organophosphorus pesticide; therefore, hemoperfusion is performed in combination with treatment with anticholinergic drugs and cholinesterase agents, and other comprehensive treatment measures should be taken to support the respiratory and circulatory function (Hu et al, 2014). All patients in our study completed the hemoperfusion treatment and were successfully treated for lowering of the intracranial pressure and cerebral edema, were weaned from ventilator support, and received antishock treatment.…”

Why are we Still Dialyzing Overdoses to Tricyclic Antidepressants? A subanalysis of the NPDS database

“…It is also impossible to discount regional practice differences. Indications for ECTR may vary according to the incidence of poisoning and regional expertise; for example, in the United States, hemodialysis and hemoperfusion are not considered typically useful for poisonings to organophosphate pesticides, while in parts of Asia, these techniques are often part of the standard of care (21)(22)(23).…”

Extracorporeal methods of blood glutamate scavenging: a novel therapeutic modality

“…Similar to blood glutamate scavengers, extracorporeal methods would thereby increase the concentration gradient between the brain and blood and increase the brain-to-blood glutamate efflux. The efficacy of blood glutamate reduction with HD, PD and HF has been studied in humans and animals [7,43–45]. …”