Use of Albumin-Cellulose Nitrate Microencapsulated Charcoal Hemoperfusion: in Acute Digoxin Toxicity in Dogs
The incidence of digoxin toxicity remains high (1). The recognition of the role of the kidneys in digoxin excretion and consequently the need for reduced dosage in patients with impaired renal function has diminished, but not eliminated the risk of toxicity (2). Attempts to remove substantial quantities of digoxin by either peritoneal or hemodialysis have been unsuccessful due to their low clearance rates (3). Since the vast majority of digoxin is tissue bound, any dialysis method requires a high clearance rate from serum and rapid equilibration from the tissue to plasma compartments. Albumin-cellulose nitrate microencapsulated charcoal (ACAC) hemoperfusion has been shown to be successful in the treatment of certain drug intoxications (4) in addition to its use in renal failure (5,6). More recently, this approach has been used for digoxin intoxication (7,8,9). The present study examined the use of the ACAC microcapsule artificial kidney prepared as described earlier (10,11,12), in dogs made acutely toxic with intravenous digoxin.
KeywordsToxicity Charcoal Digoxin
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