Vnitr Lek 2019, 65(6):425-432 | DOI: 10.36290/vnl.2019.076

Extracorporeal removal techniques in toxicology: part 2

Jaroslav Raděj1,2,*, Jan Horák1,2, Martin Harazim1,2, Martin Matějovič1,2
1 I. interní klinika LF UK a FN Plzeň
2 Biomedicínské centrum LF UK, Plzeň

The second part of the review deals in detail with the diagnostics and treatment of toxic alcohols poisoning and management and indication of extracorporeal removal techniques in intoxication with other drugs, theophylline, valproic acid, metformin and metformin associated lactic acidosis, respectively. The extracorporeal treatment enhances the clearance of the toxin and corrects patient's metabolic disturbances as well. It is necessary to use this treatment in severe intoxications. Indication of this invasive procedure falls within clinician's and nephrologist's competence being advised by a toxicologist. This review could help make fast decisions.

Keywords: extracorporeal treatment; hemodialysis; intoxication; overdose; poisoning

Received: July 4, 2018; Accepted: January 28, 2019; Published: June 1, 2019  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Raděj J, Horák J, Harazim M, Matějovič M. Extracorporeal removal techniques in toxicology: part 2. Vnitr Lek. 2019;65(6):425-432. doi: 10.36290/vnl.2019.076.
Download citation

References

  1. Alapat PM, Zimmerman JL. Toxicology in the critical care unit. Chest 2008; 133(4): 1006-1013. Dostupné z DOI: <http://dx.doi.org/10.1378/chest.07-1840>. Go to original source... Go to PubMed...
  2. Bayliss G. Dialysis in the poisoned patient. Hemodial Int 2010; 14(2): 158-167. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1542-4758.2009.00427.x>. Go to original source... Go to PubMed...
  3. de Pont AC. Extracorporeal treatment of intoxications. Curr Opin Crit Care 2007; 13(6): 668-673. Dostupné z DOI: <http://dx.doi.org/10.1097/MCC.0b013e3282f0febd>. Go to original source... Go to PubMed...
  4. Klímová D. Hemodialýza v terapii intoxikací. In: Sulková S (ed) et al. Hemodialýza. Maxdorf: Praha 2000: 590-608. ISBN 80-85912-22-8.
  5. Mirrakhimov AE, Barbaryan A, Gray A et al. The Role of Renal Replacement Therapy in the Management of Pharmacologic Poisonings. Int J Nephrol 2016; 2016: 3047329. Dostupné z DOI: <http://dx.doi.org/10.1155/2016/3047329>. Go to original source... Go to PubMed...
  6. Mokhlesi B, Leikin JB, Murray P et al. Adult toxicology in critical care: Part II: specific poisonings. Chest 2003; 123(3): 897-922. Dostupné z DOI: <http://dx.doi.org/10.1378/chest.123.3.897>. Go to original source... Go to PubMed...
  7. Zimmerman JL. Poisonings and overdoses in the intensive care unit: general and specific management issues. Crit Care Med 2003; 31(12): 2794-2801. Dostupné z DOI: <http://dx.doi.org/10.1097/01.CCM.0000100123.50896.F0>. Go to original source... Go to PubMed...
  8. Medscape. WebMD: New York City, New York, USA. Dostupné z WWW: <http://www.medscape.com>.
  9. UpToDate Inc. Evidence-based clinical decision support resource. Wolters Kluwer Health: Waltham, Massachusetts, USA. Dostupné z WWW: <http://www.uptodate.com>.
  10. Kraut JA, Kurtz I. Toxic alcohol ingestions: clinical features, diagnosis, and management. Clin J Am Soc Nephrol 2008; 3(1): 208-225. Dostupné z DOI: <http://dx.doi.org/10.2215/CJN.03220807>. Go to original source... Go to PubMed...
  11. Kraut JA, Mullins ME, Toxic Alcohols. N Engl J Med 2018; 378(3): 270-280. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMra1615295>. Erratum in Toxic Alcohols. [N Engl J Med 2019]. Go to original source... Go to PubMed...
  12. Garrard A, Sollee DR, Butterfield RC et al. Validation of a pre-existing formula to calculate the contribution of ethanol to the osmolar gap. Clin Toxicol (Phila) 2012; 50(7): 562-566. Dostupné z DOI: <http://dx.doi.org/10.3109/15563650.2012.704039>. Go to original source... Go to PubMed...
  13. Purssell RA, Pudek M, Brubacher J et al. Derivation and validation of a formula to calculate the contribution of ethanol to the osmolal gap. Ann Emerg Med 2001; 38(6): 653-659. Dostupné z DOI: <http://dx.doi.org/10.1067/mem.2001.119455>. Go to original source... Go to PubMed...
  14. Barceloux DG, Bond GR, Krenzelok EP et al. American Academy of Clinical Toxicology Ad Hoc Committee on the Treatment Guidelines for Methanol Poisoning. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol 2002; 40(4): 415-446. Go to original source... Go to PubMed...
  15. Barceloux DG, Krenzelok EP, Olson K et al. American Academy of Clinical Toxicology Practice Guidelines on the Treatment of Ethylene Glycol Poisoning. Ad Hoc Committee. J Toxicol Clin Toxicol 1999; 37(5): 537-560. Go to original source... Go to PubMed...
  16. Brent J Fomepizole for ethylene glycol and methanol poisoning. N Engl J Med 2009; 360(21): 2216-2223. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMct0806112>.
  17. Mégarbane B, Borron SW, Baud FJ. Current recommendations for treatment of severe toxic alcohol poisonings. Intensive Care Med 2005; 31(2): 189-195. Dostupné z DOI: <http://dx.doi.org/10.1007/s00134-004-2521-0>. Go to original source... Go to PubMed...
  18. Kraut JA. Approach to the Treatment of Methanol Intoxication. Am J Kidney Dis 2016; 68(1): 161-167. Dostupné z DOI: <http://dx.doi.org/10.1053/j.ajkd.2016.02.058>. Go to original source... Go to PubMed...
  19. Odborné doporučení pro intoxikaci - metanol (methanol, metylalkohol, dřevný líh, CH3OH). Toxikologické informační středisko, Klinika pracovního lékařství VFN a 1. LF UK Praha 2015. Dostupné z WWW: <http://www.tis-cz.cz/images/stories/PDFs/methanol2/METANOL-odborne-doporuceni-TIS-akt-8-2-2015.pdf>.
  20. Roberts DM, Yates C, Megarbane B et al. [EXTRIP Work Group]. Recommendations for the role of extracorporeal treatments in the management of acute methanol poisoning: a systematic review and consensus statement. Crit Care Med 2015; 43(2): 461-472. Dostupné z DOI: <http://dx.doi.org/10.1097/CCM.0000000000000708>. Go to original source... Go to PubMed...
  21. Hirsch DJ, Jindal KK, Wong P et al. A simple method to estimate the required dialysis time for cases of alcohol poisoning. Kidney Int 2001; 60(5): 2021-2024. Dostupné z DOI: <http://dx.doi.org/10.1046/j.1523-1755.2001.00003.x>. Go to original source... Go to PubMed...
  22. Zakharov S, Pelclova D, Navratil T et al. Intermittent hemodialysis is superior to continuous veno-venous hemodialysis/hemodiafiltration to eliminate methanol and formate during treatment for methanol poisoning. Kidney Int 2014; 86(1): 199-207. Dostupné z DOI: <http://dx.doi.org/10.1038/ki.2014.60>. Go to original source... Go to PubMed...
  23. Zakharov S, Rulisek J, Nurieva O et al. Intermittent versus continuous renal replacement therapy in acute methanol poisoning: comparison of clinical effectiveness in mass poisoning outbreaks. Ann Intensive Care 2017; 7(1): 77. <http://dx.doi.org/10.1186/s13613-017-0300-7>. Go to original source... Go to PubMed...
  24. Odborné doporučení pro intoxikaci - izopropylalkohol (isopropanol, 2-propanol, C3H7OH). Toxikologické informační středisko, Klinika pracovního lékařství VFN a 1. LF UK Praha 2012.
  25. Souhrny údajů o přípravcích. Státní ústav pro kontrolu léčiv: Praha ČR. Dostupné z WWW: <http://www.sukl.cz>.
  26. Calello DP, Liu KD, Wiegand TJ et al. Extracorporeal Treatment for Metformin Poisoning: Systematic Review and Recommendations From the Extracorporeal Treatments in Poisoning Workgroup. Crit Care Med 2015; 43(8): 1716-1730. Dostupné z DOI: <http://dx.doi.org/10.1097/CCM.0000000000001002>. Go to original source... Go to PubMed...
  27. Regolisti G, Antoniotti R, Fani F et al. Treatment of Metformin Intoxication Complicated by Lactic Acidosis and Acute Kidney Injury: The Role of Prolonged Intermittent Hemodialysis. Am J Kidney Dis 2017; 70(2): 290-296. Dostupné z DOI: <http://dx.doi.org/10.1053/j.ajkd.2016.12.010>. Go to original source... Go to PubMed...
  28. Ghannoum M, Wiegand TJ, Liu KD et al. Extracorporeal treatment for theophylline poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 2015; 53(4): 215-229. Dostupné z DOI: <http://dx.doi.org/10.3109/15563650.2015.1014907>. Go to original source... Go to PubMed...
  29. Ghannoum M, Laliberté M, Nolin TD et al. Extracorporeal treatment for valproic acid poisoning: systematic review and recommendations from the EXTRIP workgroup. Clin Toxicol (Phila) 2015; 53(5): 454-465. Dostupné z DOI: <http://dx.doi.org/10.3109/15563650.2015>. Go to original source... Go to PubMed...




Vnitřní lékařství

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.