Use of extracorporeal treatments in the management of poisonings

Kidney Int. 2018 Oct;94(4):682-688. doi: 10.1016/j.kint.2018.03.026. Epub 2018 Jun 27.

Abstract

Historically, the clinical application of extracorporeal treatments (ECTRs), such as hemodialysis or hemoperfusion, was first intended for poisoned patients. With time, ECTRs were used almost indiscriminately to facilitate the elimination of many poisons, albeit with uncertain clinical benefit. To determine the precise role of ECTRs in poisoning situations, multiple variables need to be considered including a careful risk assessment, the poison's characteristics including toxicokinetics, alternative treatments, the patient's clinical status, and intricacies of available ECTRs, all of which are reviewed in this article. Recently, evidence-based and expert opinion-based recommendations from the EXTRIP workgroup were also published to help minimize the knowledge gap in this area.

Keywords: continuous renal replacement therapy; hemodialysis; hemofiltration; pharmacokinetics; plasmapheresis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Hemoperfusion
  • Humans
  • Patient Selection*
  • Plasma Exchange
  • Plasmapheresis
  • Poisoning / therapy*
  • Renal Dialysis