In vitro and clinical studies of the removal of cortisol, thyroxine, insulin, and thyroid-stimulating hormone by coated charcoal haemoperfusion.

This study was carried out to assess the removal of free and protein-bound hormones by ACAC (albumin-collodion coated activated charcoal) and uncoated activated charcoal. Adsorptions of cortisol, thyroxine, insulin and thyroid-stimulating hormone from aqueous solution or plasma were studied in vitro. The effects of ACAC haemoperfusion on the systemic levels of these hormones were also studied in patients. Studies in vitro show that both types of charcoal efficiently remove hormones from protein-free solution. Removal of hormones from plasma depends on the proportions of free and protein-bound hormones in the plasma. Clinical results show only a low clearance for hormones which are strongly protein bound. The results suggested that the removal of hormones by activated charcoal is largely dependent on (1) the affinity of charcoal for the particular hormone, (2) molecular size of the hormone and (3) the degree of protein binding of the hormone. The results also show that ultrathin membrane coating does not alter the adsorption of the activated charcoal compared with uncoated charcoal.