de Torrente A, Rumack B H, Blair D T, Anderson R J
Nephron. 1979;24(2):71-7. doi: 10.1159/000181697.
We examined the efficacy of a new, fixed-bed, uncoated charcoal device in experimentally intoxicated dogs and in drug-intoxicated as well as chemically poisoned patients. In the animal studies, 4 h of hemoperfusion resulted in a significant decrease in the blood level of phenobarbital, salicylate, pentobarbital and glutethimide. The drug clearances varied between 97 +/- 10 and 129 +/- 6 ml/min. However, the total amount of drug removed was higher for phenobarbital and salicylate which have a small apparent volume of distribution (AVD) than for pentobarbital and glutethimide which have an AVD greater than total body water. We next treated 14 patients suffering from a wide variety of intoxications. Patients intoxicated with phenobarbital, methsuximide, chlordane and Amanita muscaria all showed a significant improvement in their clinical status. Patients intoxicated with ethchlorvynol, glutethimide, methaqualone, podophyllin and fluoroacetamide did not improve. Charcoal hemoperfusion may be useful in patients poisoned with drugs characterized by an AVD smaller than total body water. No major complications were encountered during the hemoperfusions.
我们研究了一种新型的固定床、未包衣的活性炭装置在实验性中毒犬以及药物中毒和化学中毒患者中的疗效。在动物研究中，4小时的血液灌流导致苯巴比妥、水杨酸盐、戊巴比妥和格鲁米特的血液水平显著下降。药物清除率在97±10至129±6毫升/分钟之间。然而，分布表观容积（AVD）小的苯巴比妥和水杨酸盐清除的药物总量高于AVD大于总体水的戊巴比妥和格鲁米特。接下来，我们治疗了14例患有各种中毒的患者。苯巴比妥、甲琥胺、氯丹和毒蝇伞中毒的患者临床状况均有显著改善。乙氯维诺、格鲁米特、甲喹酮、鬼臼脂和氟乙酰胺中毒的患者没有改善。血液灌流可能对分布表观容积小于总体水的药物中毒患者有用。血液灌流过程中未出现重大并发症。
