The Role of Charcoal Haemoperfusion in the Management of Acute Poisoning by Drugs

Summary

Haemoperfusion has been carried out, in a series of 21 patients suffering from acute drug overdosage, using a commercially available column containing activated charcoal coated with acrylic hydrogel. The patients selected were in all cases those with evidence of severe intoxication and very high plasma drug levels together with complications such as bronchopneumonia. Sixteen patients survived and five died, four from cerebral damage which occurred before haemoperfusion and one from a complication of disease unrelated to the drug overdose. The treatment was free from major side effects and in the patients who survived it appeared to make a real contribution towards recovery. A survey of severely poisoned patients referred to the Poisons Unit for laboratory analysis suggests that this method of treatment may have an important role to play in reducing the mortality and morbidity of the severely poisoned patient,articularly in those cases who have taken short or medium acting barbiturates or nonbarbiturate hypnotics. It is suggested that this technique is now suitable for further clinical evaluation and that this should be carried out at specialist, regional units with adequate laboratory facilities.