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In Support of Hemodialysis and Hemoperfusion

In Support of Hemodialysis and Hemoperfusion Abstract To the Editor. —The case report in the June 1981 Archives (141:938-940) concerning the use of dopamine hydrochloride to support an alkaline diuresis in the treatment of phenobarbital overdose is most disturbing. This patient, with a lethal plasma concentration of phenobarbital, was allowed to remain comatose for five days and intubated for six days, while the drug was slowly excreted via forced alkaline diuresis. The authors are to be commended on the excellent intensive care they gave this patient. It is unfortunate that a more efficient method of removing the drug was not used.The case report indicates that "dialysis was considered, but because of the clinical situation and practical considerations" was not used. Our extensive experience, and the extensive reports in the literature, indicate that these patients are rarely too sick to tolerate hemodialysis or hemoperfusion. Phenobarbital can be readily dialyzed, but a more modern approach would be to References 1. Winchester JF, Gelfand MC, Knepshield JH, et al: Dialysis and hemoperfusion of poisons and drugs: Update. Trans Am Soc Artif Intern Organs 1977;23:762-842.Crossref 2. Holt IE, Holz PH: The black bottle: A consideration of the role of charcoal in the treatment of poisoning of children. J Pediatr 1963;63:306.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

In Support of Hemodialysis and Hemoperfusion

Abstract

Abstract To the Editor. —The case report in the June 1981 Archives (141:938-940) concerning the use of dopamine hydrochloride to support an alkaline diuresis in the treatment of phenobarbital overdose is most disturbing. This patient, with a lethal plasma concentration of phenobarbital, was allowed to remain comatose for five days and intubated for six days, while the drug was slowly excreted via forced alkaline diuresis. The authors are to be commended on the excellent intensive care...
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Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1982.00340160226049
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor. —The case report in the June 1981 Archives (141:938-940) concerning the use of dopamine hydrochloride to support an alkaline diuresis in the treatment of phenobarbital overdose is most disturbing. This patient, with a lethal plasma concentration of phenobarbital, was allowed to remain comatose for five days and intubated for six days, while the drug was slowly excreted via forced alkaline diuresis. The authors are to be commended on the excellent intensive care they gave this patient. It is unfortunate that a more efficient method of removing the drug was not used.The case report indicates that "dialysis was considered, but because of the clinical situation and practical considerations" was not used. Our extensive experience, and the extensive reports in the literature, indicate that these patients are rarely too sick to tolerate hemodialysis or hemoperfusion. Phenobarbital can be readily dialyzed, but a more modern approach would be to References 1. Winchester JF, Gelfand MC, Knepshield JH, et al: Dialysis and hemoperfusion of poisons and drugs: Update. Trans Am Soc Artif Intern Organs 1977;23:762-842.Crossref 2. Holt IE, Holz PH: The black bottle: A consideration of the role of charcoal in the treatment of poisoning of children. J Pediatr 1963;63:306.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1982

References