Higgins R M, Hearing S, Goldsmith D J, Keevil B, Venning M C, Ackrill P
Renal Unit, Withington Hospital, Manchester, UK.
Postgrad Med J. 1995 Apr;71(834):224-6. doi: 10.1136/pgmj.71.834.224.
Theophylline poisoning with a blood level of 183 mg/l in a 38-year-old man was treated with activated charcoal by mouth, but despite this the blood level of theophylline rose and there was circulatory collapse with rhabdomyolysis, acute renal failure and hyperthermia. Treatment with charcoal haemoperfusion and simultaneous haemodialysis was given, followed by continuous arteriovenous haemodialysis (CAVHD). Mean extraction rates of theophylline were 26% during CAVHD, and 86% during combined dialysis and charcoal haemoperfusion. During combined treatment, the mean extraction rate of haemodialysis was 62%, compared with 48% for charcoal haemoperfusion. In summary, activated charcoal given by mouth may be unable to prevent a rise in blood levels and the development of complications after substantial theophylline overdose. If theophylline is to be removed from the blood, a combination of charcoal haemoperfusion and haemodialysis will give the best clearance, but haemodialysis alone may be effective.
一名38岁男性茶碱中毒，血药浓度达183mg/l，口服活性炭进行治疗，但尽管如此，茶碱血药浓度仍上升，出现循环衰竭，并伴有横纹肌溶解、急性肾衰竭和高热。给予活性炭血液灌流并同时进行血液透析治疗，随后进行持续动静脉血液透析（CAVHD）。CAVHD期间茶碱的平均清除率为26%，联合透析和活性炭血液灌流期间为86%。联合治疗期间，血液透析的平均清除率为62%，活性炭血液灌流为48%。总之，口服活性炭可能无法防止血药浓度上升以及大量茶碱过量服用后并发症的发生。如果要从血液中清除茶碱，活性炭血液灌流和血液透析联合使用清除效果最佳，但单独血液透析也可能有效。
