Clinical Efficacy Of Haemoperfusion In Treating Poisoning

Objective: With a controlled clinical trial, the efficacy clearance of haemoperfusion and its clinical efficacy was evaluated.Methods: Sixty-nine cases of medicine and tetramine poisoning in hospital from July, 1990 to March, 2004 were studied. Thirty-four patients received multiple treatment (including early gastric lavage, protection liver, diuresis or respiratory support), and the rest were given the comprehensive managements and haemoperfusion. Medicine or tetramine blood concentration was detected before and after haemoperfusion. The following parameters were observed: (1) changes of blood concentration after haemoperfusion, survival rate, the time of having consciousness , convulsion termination, and clinical course. (2) The changes of blood pressure and adverse reactions were recorded during the haemoperfusion therapy. (3) The changes of blood cell count before and after perfusion with two kinds of adsorbents (activated charcoal and resin).Results: (l)In hemperfusion group, the survival rate was 91.4%, non-haemoperfusion group, the survival rate was 85.3% (p >0.05); Meanwhile the clinical course was markedly shorted in hemperfusion group (p <0.05). The time from coma to having consciousness and convulsion termination was significantly shorter than that of non-haemoperfusion group; Clearance rate was different with different poisons, Of them the benzodiazepines were eliminated by (91.6 ?12.5) %. (2) All patients' blood pressure transient changed a little during hemoperfusion and fell down a lowest level after 15~30 minutes hemperfusion, systoltic blood pressure levels being (120.64 + 19.85)mmHg before perfusion was down to (107.59 ?13.94)mmHg after 0.5 h hemperfusion, but up again to a mean of (115.74?2.30)mniHg after 2h. Platelet counts were decreased significantly using both activated charcoal and resin adsorbent,but haemoglobin and white-cell counts showed no changes during hemoperfusionConclusions: Haemoperfusion can remove some poisons in different levels from the blood, shorten clinical course and reduce complication. It may raise survival rate to serious poisoning. Although 25% patients systolic blood pressure transient fell to 90mmHg or below at early hemoperfusion periods, no case was needed termination of perfusion. Blood pressure rose after a colloid infusion. Since activated charcoal adsorbent showed a more significant decreasing effect on platelet than resin adsorbent (Haemoresin), it is suggested that resin cartridge should be used in the low level platelet patients.