Hemoperfusion to treat intoxications
Hemoperfusion is being increasingly proposed and used for the treatment of a large variety of exogenous intoxications. This procedure has been shown to achieve high clearance rates of most common intoxicants, and case reports have claimed that its application has been, on occasion, life-saving. We tabulated our experience in the treatment of 94 consecutive patients with severe intoxications who were treated with supportive management only; this group constituted 25% of all patients admitted with a diagnosis of drug overdose. Of the 94 patients only one died; all others were discharged without sequelae resulting from the intoxication or its complications; only 21% required more than a 48-hour stay in the intensive care unit. We propose that supportive management must remain the mainstay of therapy even in severely intoxicated patients; with few exceptions, hemoperfusion must be considered an as yet unproven form of therapy; further controlled studies are necessary to establish its range of indications, potential benefits, and cost effectiveness.