The Experts below are selected from a list of 84 Experts worldwide ranked by ideXlab platform

Thomas W. Smith - One of the best experts on this subject based on the ideXlab platform.

  • The use of digoxin-specific Fab fragments for severe Digitalis Intoxication in children.
    The New England journal of medicine, 1992
    Co-Authors: Alan D. Woolf, Thomas W. Smith, Thomas L. Wenger, Frederick H. Lovejoy
    Abstract:

    Abstract Background. Because life-threatening Digitalis Intoxication is unusual in children, treatment with digoxin-specific—antibody Fab fragments (Fab) has rarely been reported. We describe the efficacy of Fab in the treatment of children with severe Digitalis Intoxication. Methods. Twenty-nine children with Intoxication due to digoxin (28) or digitoxin (1) received Fab at 21 participating hospitals between 1974 and 1986. Data were gathered about the patients' medical illnesses, doses and serum concentrations of Digitalis, responses to Fab therapy, and outcomes. Results. In the infants and young children with acute digoxin Intoxication, the digoxin doses ranged from 0.30 to 0.96 mg per kilogram of body weight; two adolescents had severe Intoxication after doses of only 0.20 and 0.26 mg per kilogram. The serum digoxin concentrations ranged from 3.0 to >100 ng per milliliter (mean, 13.8). Atrioventricular block (present in 22 patients [76 percent]) was the most common sign of toxicity. All the patients in...

  • DIGOXIN IMMUNE FAB THERAPY IN THE MANAGEMENT OF Digitalis Intoxication : SAFETY, AND EFFICACY RESULTS OF AN OBSERVATIONAL SURVEILLANCE STUDY
    Journal of the American College of Cardiology, 1991
    Co-Authors: Anne R. Hickey, Thomas L. Wenger, Vincent P. Carpenter, Hugh H. Tilson, Mark A. Hlatky, Curt D. Furberg, Charles H. Kirkpatrick, Harold C. Strauss, Thomas W. Smith
    Abstract:

    An observational surveillance study was conducted to monitor the safety and effectiveness of treatment with Digoxin Immune Fab (Ovine) (Digibind) in patients with Digitalis Intoxication. Before April 1986, a relatively limited number of patients received treatment with digoxin-specific Fab fragments through a multicenter clinical trial. Beginning with commercial availability in July 1986, this study sought additional, voluntarily reported clinical data pertaining to treatment through a 3 week follow-up. The study included 717 adults who received Digoxin Immune Fab (Ovine). Most patients were ≥70 years old and developed toxicity during maintenance dosing with digoxin. Fifty percent of patients were reported to have a complete response to treatment, 24% a partial response and 12% no response. The response for 14% of patients was not reported or reported as uncertain. Six patients (0.8%, 95% confidence interval 0.3% to 1.8%) had an allergic reaction to digoxin-specific antibody fragments. Three of the six had a history of allergy to antibiotic drugs. Twenty patients (2.8%, 95% confidence interval 1.7% to 4.3%) developed recrudescent toxicity. Risk of recrudescent toxicity increased sixfold when Digoxin-specific antibody fragments were generally well tolerated and clinically effective in patients judged by treating physicians to have potentially life-threatening Digitalis Intoxication.

  • Results of multicenter studies of digoxin-specific antibody fragments in managing Digitalis Intoxication in the pediatric population.
    The American journal of emergency medicine, 1991
    Co-Authors: Alan D. Woolf, Thomas W. Smith, Thomas L. Wenger, Frederick H. Lovejoy
    Abstract:

    Digitalis toxicity continues to be a problem for pediatric patients undergoing therapy with cardiac glycosides for heart failure or arrhythmias, as well as in accidental ingestions. In this article the previous use of digoxin-specific antibody Fab fragments to treat Digitalis overdose or Intoxication in children is reviewed. The case reports cited in the medical literature and the 57 pediatric cases gathered as a result of the multicenter clinical trial and postmarketing surveillance study reported here indicate that digoxin-specific antibody Fab fragments are effective in ameliorating signs of Digitalis poisoning in children. Not only can Fab fragments rapidly eradicate potentially life-threatening arrhythmias and conduction defects, but they are also effective in treating hyperkalemia and other noncardiac manifestations of Digitalis toxicity. In the small samples of patients studied to date, complications have been minimal and no allergic reactions to digoxin-specific Fab fragments have been observed. Recommendations for the management of Digitalis Intoxication in children are outlined.

Thomas L. Wenger - One of the best experts on this subject based on the ideXlab platform.

  • The use of digoxin-specific Fab fragments for severe Digitalis Intoxication in children.
    The New England journal of medicine, 1992
    Co-Authors: Alan D. Woolf, Thomas W. Smith, Thomas L. Wenger, Frederick H. Lovejoy
    Abstract:

    Abstract Background. Because life-threatening Digitalis Intoxication is unusual in children, treatment with digoxin-specific—antibody Fab fragments (Fab) has rarely been reported. We describe the efficacy of Fab in the treatment of children with severe Digitalis Intoxication. Methods. Twenty-nine children with Intoxication due to digoxin (28) or digitoxin (1) received Fab at 21 participating hospitals between 1974 and 1986. Data were gathered about the patients' medical illnesses, doses and serum concentrations of Digitalis, responses to Fab therapy, and outcomes. Results. In the infants and young children with acute digoxin Intoxication, the digoxin doses ranged from 0.30 to 0.96 mg per kilogram of body weight; two adolescents had severe Intoxication after doses of only 0.20 and 0.26 mg per kilogram. The serum digoxin concentrations ranged from 3.0 to >100 ng per milliliter (mean, 13.8). Atrioventricular block (present in 22 patients [76 percent]) was the most common sign of toxicity. All the patients in...

  • DIGOXIN IMMUNE FAB THERAPY IN THE MANAGEMENT OF Digitalis Intoxication : SAFETY, AND EFFICACY RESULTS OF AN OBSERVATIONAL SURVEILLANCE STUDY
    Journal of the American College of Cardiology, 1991
    Co-Authors: Anne R. Hickey, Thomas L. Wenger, Vincent P. Carpenter, Hugh H. Tilson, Mark A. Hlatky, Curt D. Furberg, Charles H. Kirkpatrick, Harold C. Strauss, Thomas W. Smith
    Abstract:

    An observational surveillance study was conducted to monitor the safety and effectiveness of treatment with Digoxin Immune Fab (Ovine) (Digibind) in patients with Digitalis Intoxication. Before April 1986, a relatively limited number of patients received treatment with digoxin-specific Fab fragments through a multicenter clinical trial. Beginning with commercial availability in July 1986, this study sought additional, voluntarily reported clinical data pertaining to treatment through a 3 week follow-up. The study included 717 adults who received Digoxin Immune Fab (Ovine). Most patients were ≥70 years old and developed toxicity during maintenance dosing with digoxin. Fifty percent of patients were reported to have a complete response to treatment, 24% a partial response and 12% no response. The response for 14% of patients was not reported or reported as uncertain. Six patients (0.8%, 95% confidence interval 0.3% to 1.8%) had an allergic reaction to digoxin-specific antibody fragments. Three of the six had a history of allergy to antibiotic drugs. Twenty patients (2.8%, 95% confidence interval 1.7% to 4.3%) developed recrudescent toxicity. Risk of recrudescent toxicity increased sixfold when Digoxin-specific antibody fragments were generally well tolerated and clinically effective in patients judged by treating physicians to have potentially life-threatening Digitalis Intoxication.

  • Results of multicenter studies of digoxin-specific antibody fragments in managing Digitalis Intoxication in the pediatric population.
    The American journal of emergency medicine, 1991
    Co-Authors: Alan D. Woolf, Thomas W. Smith, Thomas L. Wenger, Frederick H. Lovejoy
    Abstract:

    Digitalis toxicity continues to be a problem for pediatric patients undergoing therapy with cardiac glycosides for heart failure or arrhythmias, as well as in accidental ingestions. In this article the previous use of digoxin-specific antibody Fab fragments to treat Digitalis overdose or Intoxication in children is reviewed. The case reports cited in the medical literature and the 57 pediatric cases gathered as a result of the multicenter clinical trial and postmarketing surveillance study reported here indicate that digoxin-specific antibody Fab fragments are effective in ameliorating signs of Digitalis poisoning in children. Not only can Fab fragments rapidly eradicate potentially life-threatening arrhythmias and conduction defects, but they are also effective in treating hyperkalemia and other noncardiac manifestations of Digitalis toxicity. In the small samples of patients studied to date, complications have been minimal and no allergic reactions to digoxin-specific Fab fragments have been observed. Recommendations for the management of Digitalis Intoxication in children are outlined.

Frederick H. Lovejoy - One of the best experts on this subject based on the ideXlab platform.

  • The use of digoxin-specific Fab fragments for severe Digitalis Intoxication in children.
    The New England journal of medicine, 1992
    Co-Authors: Alan D. Woolf, Thomas W. Smith, Thomas L. Wenger, Frederick H. Lovejoy
    Abstract:

    Abstract Background. Because life-threatening Digitalis Intoxication is unusual in children, treatment with digoxin-specific—antibody Fab fragments (Fab) has rarely been reported. We describe the efficacy of Fab in the treatment of children with severe Digitalis Intoxication. Methods. Twenty-nine children with Intoxication due to digoxin (28) or digitoxin (1) received Fab at 21 participating hospitals between 1974 and 1986. Data were gathered about the patients' medical illnesses, doses and serum concentrations of Digitalis, responses to Fab therapy, and outcomes. Results. In the infants and young children with acute digoxin Intoxication, the digoxin doses ranged from 0.30 to 0.96 mg per kilogram of body weight; two adolescents had severe Intoxication after doses of only 0.20 and 0.26 mg per kilogram. The serum digoxin concentrations ranged from 3.0 to >100 ng per milliliter (mean, 13.8). Atrioventricular block (present in 22 patients [76 percent]) was the most common sign of toxicity. All the patients in...

  • Results of multicenter studies of digoxin-specific antibody fragments in managing Digitalis Intoxication in the pediatric population.
    The American journal of emergency medicine, 1991
    Co-Authors: Alan D. Woolf, Thomas W. Smith, Thomas L. Wenger, Frederick H. Lovejoy
    Abstract:

    Digitalis toxicity continues to be a problem for pediatric patients undergoing therapy with cardiac glycosides for heart failure or arrhythmias, as well as in accidental ingestions. In this article the previous use of digoxin-specific antibody Fab fragments to treat Digitalis overdose or Intoxication in children is reviewed. The case reports cited in the medical literature and the 57 pediatric cases gathered as a result of the multicenter clinical trial and postmarketing surveillance study reported here indicate that digoxin-specific antibody Fab fragments are effective in ameliorating signs of Digitalis poisoning in children. Not only can Fab fragments rapidly eradicate potentially life-threatening arrhythmias and conduction defects, but they are also effective in treating hyperkalemia and other noncardiac manifestations of Digitalis toxicity. In the small samples of patients studied to date, complications have been minimal and no allergic reactions to digoxin-specific Fab fragments have been observed. Recommendations for the management of Digitalis Intoxication in children are outlined.

Ole-jørgen Ohm - One of the best experts on this subject based on the ideXlab platform.

  • Immediate control of life-threatening digoxin Intoxication in a child by use of digoxin-specific antibody fragments (Fab).
    Paediatric anaesthesia, 2003
    Co-Authors: Paul Husby, M. Farstad, John G. Brock-utne, M. E. Koller, Leidulf Segadal, T. Lund, Ole-jørgen Ohm
    Abstract:

    Digoxin-immune antibody fragments (Fab) for treatment of Digitalis Intoxication was introduced in 1976. Many reports have been published concerning this therapy for children, but few have focused on its immediate reversal of cardiac as well as extracardiac life-threatening manifestations of digoxin toxicity. We present a case of life-threatening Digitalis Intoxication in a child with postoperative renal insufficiency, after a Sennings procedure for transposition of the great arteries. Digoxin administration according to the nationally recommended dosage and intervals unexpectedly resulted in serum levels in the toxic range. Severe cardiac arrhythmias, haemodynamic instability and a rapid-increasing serum potassium level resulted. This report demonstrates how administration of Fab according to the manufacturer's dosage recommendation reversed the tachyarrhythmia immediately and re-established a normal level of serum potassium within minutes.

Anne R. Hickey - One of the best experts on this subject based on the ideXlab platform.

  • DIGOXIN IMMUNE FAB THERAPY IN THE MANAGEMENT OF Digitalis Intoxication : SAFETY, AND EFFICACY RESULTS OF AN OBSERVATIONAL SURVEILLANCE STUDY
    Journal of the American College of Cardiology, 1991
    Co-Authors: Anne R. Hickey, Thomas L. Wenger, Vincent P. Carpenter, Hugh H. Tilson, Mark A. Hlatky, Curt D. Furberg, Charles H. Kirkpatrick, Harold C. Strauss, Thomas W. Smith
    Abstract:

    An observational surveillance study was conducted to monitor the safety and effectiveness of treatment with Digoxin Immune Fab (Ovine) (Digibind) in patients with Digitalis Intoxication. Before April 1986, a relatively limited number of patients received treatment with digoxin-specific Fab fragments through a multicenter clinical trial. Beginning with commercial availability in July 1986, this study sought additional, voluntarily reported clinical data pertaining to treatment through a 3 week follow-up. The study included 717 adults who received Digoxin Immune Fab (Ovine). Most patients were ≥70 years old and developed toxicity during maintenance dosing with digoxin. Fifty percent of patients were reported to have a complete response to treatment, 24% a partial response and 12% no response. The response for 14% of patients was not reported or reported as uncertain. Six patients (0.8%, 95% confidence interval 0.3% to 1.8%) had an allergic reaction to digoxin-specific antibody fragments. Three of the six had a history of allergy to antibiotic drugs. Twenty patients (2.8%, 95% confidence interval 1.7% to 4.3%) developed recrudescent toxicity. Risk of recrudescent toxicity increased sixfold when Digoxin-specific antibody fragments were generally well tolerated and clinically effective in patients judged by treating physicians to have potentially life-threatening Digitalis Intoxication.