Cabrera Valerie Jorge, Shirali Anushree C
Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut.
Semin Dial. 2016 Jul;29(4):275-7. doi: 10.1111/sdi.12505. Epub 2016 Apr 29.
Extracorporeal modalities for the removal of drugs and toxins are indicated for the treatment of overdoses and intoxications. Well-established modalities include hemodialysis (HD), high-flux HD (HfD), and charcoal hemoperfusion (HP). Recently, there have been increasing reports on the use of continuous renal replacement therapy (CRRT), such as continuous veno-venous hemodialysis (CVVHD), continuous veno-venous hemofiltration (CVVH) or CVVH combined with dialysis (CVVHDF). In the present article, we will discuss the various factors that determine the clearance of drugs and toxins and accordingly, we will propose that with few exceptions, CRRT does not have a role in the routine management of intoxications.
用于清除药物和毒素的体外模式适用于治疗药物过量和中毒。成熟的模式包括血液透析(HD)、高通量血液透析(HfD)和活性炭血液灌流(HP)。最近,关于使用连续性肾脏替代治疗(CRRT)的报道越来越多,如连续性静脉-静脉血液透析(CVVHD)、连续性静脉-静脉血液滤过(CVVH)或CVVH联合透析(CVVHDF)。在本文中,我们将讨论决定药物和毒素清除率的各种因素,因此,我们将提出,除少数例外情况外,CRRT在中毒的常规管理中没有作用。