Critical, Acutely Poisoned Patients Treated With Continuous Arteriovenous Hemoperfusion in the Emergency Department, ,

Study objective: To investigate the efficiency of a new nonpump 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. [Lin J-L, Jeng L-B: Critical, acutely poisoned patients treated with continuous arteriovenous hemoperfusion in the emergency department. Ann Emerg Med January 1995;25:75-80.]