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Principles and Operational Parameters to Optimize Poison Removal with Extracorporeal Treatments
Author(s) -
Bouchard Josée,
Roberts Darren M.,
Roy Louise,
Ouellet Georges,
Decker Brian S.,
Mueller Bruce A.,
Desmeules Simon,
Ghannoum Marc
Publication year - 2014
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12247
Subject(s) - medicine , extracorporeal , intensive care medicine , surgery
A role for nephrologists in the management of a poisoned patient involves evaluating the indications for, and methods of, enhancing the elimination of a poison. Nephrologists are familiar with the various extracorporeal treatments ( ECTR s) used in the management of impaired kidney function, and their respective advantages and disadvantages. However, these same skills and knowledge may not always be considered, or applicable, when prescribing ECTR for the treatment of a poisoned patient. Maximizing solute elimination is a key aim of such treatments, perhaps more so than in the treatment of uremia, because ECTR has the potential to reverse clinical toxicity and shorten the duration of poisoning. This manuscript reviews the various principles that govern poison elimination by ECTR (diffusion, convection, adsorption, and centrifugation) and how components of the ECTR can be adjusted to maximize clearance. Data supporting these recommendations will be presented, whenever available.