The Experts below are selected from a list of 213 Experts worldwide ranked by ideXlab platform

Mingjiuh Wang - One of the best experts on this subject based on the ideXlab platform.

Andrew H Dawson - One of the best experts on this subject based on the ideXlab platform.

  • efficacy of charcoal Hemoperfusion in massive carbamazepine poisoning
    Clinical Toxicology, 2002
    Co-Authors: Robert J Cameron, P Hungerford, Andrew H Dawson
    Abstract:

    Background: Carbamazepine poisoning can be life threatening. The role and efficacy of extracorporeal drug clearance is not clearly defined. Case Report: A 16-year-old male ingested 34 g of slow-release carbamazepine. His course was complicated by seizures, recurrent cardiac arrests, and renal failure. Intestinal ileus at the time of presentation prevented effective gastrointestinal decontamination. His carbamazepine concentration peaked at 93.8 mg/L (397 μmol/L) 106 hours after ingestion. There was evidence suggesting ongoing absorption for 120 hours. He underwent seven episodes of charcoal Hemoperfusion for a total of 109.25 hours. He subsequently made a full recovery. Methods: The efficacy of charcoal Hemoperfusion was evaluated by measuring the carbamazepine concentrations in the afferent and efferent loops of the Hemoperfusion cartridge using 17 paired convenience samples. Extraction ratios were calculated and plotted against time for each individual episode of charcoal Hemoperfusion. Conclusion: The ...

Wenpyng Wu - One of the best experts on this subject based on the ideXlab platform.

  • addition of immunosuppressive treatment to Hemoperfusion is associated with improved survival after paraquat poisoning a nationwide study
    PLOS ONE, 2014
    Co-Authors: Wenpyng Wu, Yufen Li, Mingju Wu
    Abstract:

    Paraquat poisoning associates very high mortality rate. Early treatment with Hemoperfusion is strongly suggested by animal and human studies. Although the survival benefit of additional immunosuppressive treatment (IST) in combination with Hemoperfusion is also reported since 1971, the large-scale randomized control trials to confirm the effects of IST is difficult to be executed. Therefore, we designed this nationwide large-scale population-based retrospective cohort study to investigate the outcome of paraquat poisoning with Hemoperfusion and the additional effects of IST combined with Hemoperfusion. This nationwide retrospective cohort study utilized data retrieved from the National Health Insurance Research Database (NHIRD) of Taiwan. A total of 1811 hospitalized patients with a diagnosis of paraquat poisoning who received Hemoperfusion between 1997 and 2009 were enrolled. The mean age of all 1811 study subjects was 47.3 years. 70% was male. The overall survival rate was only 26.4%. Respiratory failure and renal failure were diagnosed in 56.2% and 36% patients. The average frequency of Hemoperfusion was twice. IST was added in 42.2% patients. IST significantly increases survival rate (from 24.3% to 29.3%, P<0.001). The combined IST with methylprednisolone, cyclophosphamide and dexamethasone associates with the highest survival rate (48%, P<0.001). Moreover, patients younger than 45 years of age in the IST group had the best survival (41.0% vs. 33.7%, p<0.001). Our results support the use of IST with Hemoperfusion for paraquat-poisoned patients. The best survival effect of IST is the combination of methylprednisolone, cyclophosphamide and daily dexamethasone, especially in patients with younger age.

Dra Uges - One of the best experts on this subject based on the ideXlab platform.

  • valproic acid toxicokinetics serial hemodialysis and Hemoperfusion
    Therapeutic Drug Monitoring, 1999
    Co-Authors: Ejf Franssen, G G Van Essen, A T Portman, G Go, Coen A Stegeman, Dra Uges
    Abstract:

    The toxicity and pharmacokinetic properties of a drug determine whether hemodialysis and/or Hemoperfusion are indicated in acute intoxications. Valproic acid is considered unremovable by hemodialysis because of the high protein binding of 90%-95%. A 27-year-old male with a history of seizures was admitted to the emergency room because of coma, hypernatriemia, and respiratory failure caused by an intoxication with a large dose of valproic acid. At admission; the plasma valproic acid level was 1414 mg/L (9.9 mmol/L) (therapeutic range: 50-100 mg/L (350-700 umol/L). The anion gap was 26 mmol/L (normal <12-14 mmol/L) and corresponded fairly well with this valproic acid level. Because of the potential toxicity of this high valproic acid level serial hemodialysis and Hemoperfusion was performed. The first session was done with a charcoal column and the second session with a resin column. The patient recovered during the course of treatment. The valproic acid plasma clearances during treatment were: 80 mL/min (hemodialysis); 40 mL/min (Hemoperfusion by charcoal) and 80 mL/min (Hemoperfusion by resin, only in the first hour). The protein binding of valproic acid in plasma was only 32% at the start and was 54% at the end of the two sessions. In this specific case of a severe valproic acid intoxication, saturated protein binding resulted in an increased fraction of unbound valproic acid. This made hemodialysis an effective treatment, while Hemoperfusion was relatively less effective because of saturation of the column. In conclusion, the toxicokinetics of valproate are quite different from the pharmacokinetics at therapeutic levels. The anion gap and protein binding are important parameters in toxicokinetics.

Tzu Chang - One of the best experts on this subject based on the ideXlab platform.