Stalker N E, Gambertoglio J G, Fukumitsu C J, Naughton J L, Benet L Z
J Clin Pharmacol. 1978 Feb-Mar;18(2-3):136-42. doi: 10.1002/j.1552-4604.1978.tb02434.x.
A 38-year-old female became comatose and exhibited signs of cardiac toxicity 2 hours after ingestion of approximately 38 Gm chloral hydrate. Hemodialysis was initiated 21 hours after ingestion, using twin coils in series, and was continued for 4.5 hours. Trichloroethanol, the active metabolite of chloral hydrate, was measured in plasma and dialysate. Two hours after ingestion, the plasma level was 330 micrograms/ml (average therapeutic level is 12 micrograms/ml or less). The predialysis level was 216 micrograms/ml and after dialysis declined to 141 micrograms/ml. The pre- and post-plasma half-life values were 35 hours, while on dialysis the half-life was only 6 hours. The average dialysis clearance was 120 ml/minute, and the amount of chloral hydrate removed by dialysis was 5.79 Gm. By the end of dialysis, the patient could respond to verbal commands and was ambulatory 36 hours later. In conclusion, hemodialysis can be a clinically important method of treating chloral hydrate overdose.
一名38岁女性在摄入约38克水合氯醛2小时后昏迷，并出现心脏毒性迹象。摄入21小时后开始进行血液透析，采用串联双线圈，持续4.5小时。测定了血浆和透析液中水合氯醛的活性代谢产物三氯乙醇。摄入2小时后，血浆水平为330微克/毫升（平均治疗水平为12微克/毫升或更低）。透析前水平为216微克/毫升，透析后降至141微克/毫升。血浆透析前和透析后半衰期值为35小时，而透析时半衰期仅为6小时。平均透析清除率为120毫升/分钟，透析清除的水合氯醛量为5.79克。透析结束时，患者能够对言语指令做出反应，36小时后可下床活动。总之，血液透析可能是治疗水合氯醛过量的一种重要临床方法。
