Critical, acutely poisoned patients treated with continuous arteriovenous hemoperfusion in the emergency department.

STUDY OBJECTIVE

To investigate the efficiency of a new non-pump hemoperfusion technique, continuous arteriovenous hemoperfusion, in the treatment of critical, acutely poisoned patients.

SETTING

Emergency department of a general hospital.

PARTICIPANTS

Acutely poisoned patients who failed to respond to intensive supportive treatment and needed hemoperfusion therapy.

INTERVENTIONS

All patients received continuous arteriovenous hemoperfusion therapy for 4 to 8 hours. Toxicant clearances were determined by obtaining serial theophylline and phenobarbital levels every 2 hours before, during, and after continuous arteriovenous hemoperfusion. Platelet counts, whole-blood activated clotting time, and vital signs were monitored.

RESULTS

The clinical condition of these patients improved rapidly after continuous arteriovenous hemoperfusion was started. The treatments were performed easily, and no significant complications occurred. The clearances of theophylline and phenobarbital were 192.79 +/- 1.55 mL/min and 290.25 +/- 25.33 mL/min, respectively, similar to those of conventional hemoperfusion.

CONCLUSION

Continuous arteriovenous hemoperfusion is a simple, safe, effective, and less costly alternative to conventional hemoperfusion, especially in the EDs of hospitals without hemoperfusion facilities immediately available.