The Japanese Journal of Clinical Dialysis Vol.26 No.10(11)

Theme Acute Blood Purification Therapy
Title Blood purification for drug intoxication
Publish Date 2010/09
Author Hajime Nakae Department of Emergency and Critical Care Medicine, Akita University Graduate School of Medicine
[ Summary ] Blood purification is administered in cases of drug intoxication when the substances causing the intoxication must be eliminated. This is especially true when the substances lead to organ dysfunction, such as renal or hepatic failure. The causative substances are a wide ranging. In removing these substances, gastric lavage, activated carbon administration, laxative administration, or enema cleansing are the preferred methods. Blood purification is not routinely conducted in these cases. However, when the causative substance is unknown or when there are several causative substances, it is not easy to immediately develop a treatment strategy or to judge whether or not blood purification should be performed. In such cases, blood purification must be conducted in a timely manner and in accordance with the crisis management principle of "Prepare for the worst." In general, substances, the molecular weight of which is within the removal spectrum, having a small distribution volume and a low protein-binding rate, are easier to remove. For substances with high protein-binding rates, albumin dialysis using MARS and Prometheus is performed in order to remove albumin-binding substances. Since MARS and Prometheus have not been introduced in Japan, plasma dia-filtration(PDF), employing selective plasma filtration with dialysis, is a practical alternative.
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