Köppel C, Martens F, Schirop T, Ibe K
Klinikum Rudolf Virchow, Freie Universität Berlin.
Intensive Care Med. 1988;14(4):431-3. doi: 10.1007/BF00262902.
After ingestion of an unknown dose of a 10% camphor spirit (maximum dose 200 ml), a 54-year-old female was found in coma, having developed grand-mal-like seizures and respiratory failure. For detoxification, gastric lavage and hemoperfusion with amberlite XAD4 were performed. During hemoperfusion, seizures ceased, but no marked influence on the clinical course of the intoxication--especially on grade of coma--was observed. For further evaluation of the efficacy of treatment, camphor plasma elimination kinetics during hemoperfusion were compared to plasma elimination kinetics determined in a volunteer after an oral dose of 200 mg of camphor. Although the plasma compartment was almost completely (89%-95%) cleared of camphor by hemoperfusion, only a total of 35 mg of camphor was removed due to its high apparent volume of distribution (estimated 2-4 l/kg). The plasma elimination half-life was not affected by hemoperfusion, which may be explained by the saturation of metabolizing enzymes, still incomplete absorption, or metabolic interference of isopropanol. In the case presented here, neither the clinical course of the intoxication nor plasma level data gave evidence for a pronounced beneficial effect of hemoperfusion.
一名54岁女性在摄入未知剂量的10%樟脑醑（最大剂量200毫升）后，出现昏迷、大发作样癫痫和呼吸衰竭。为进行解毒，进行了洗胃和用Amberlite XAD4进行血液灌流。在血液灌流过程中，癫痫发作停止，但未观察到对中毒临床过程（尤其是昏迷程度）有明显影响。为进一步评估治疗效果，将血液灌流期间樟脑的血浆消除动力学与一名志愿者口服200毫克樟脑后测定的血浆消除动力学进行了比较。尽管血液灌流几乎完全（89%-95%）清除了血浆中的樟脑，但由于其表观分布容积高（估计为2-4升/千克），仅总共清除了35毫克樟脑。血液灌流未影响血浆消除半衰期，这可能是由于代谢酶饱和、吸收仍不完全或异丙醇的代谢干扰所致。在此病例中，中毒的临床过程和血浆水平数据均未表明血液灌流有明显的有益效果。
