Resin Hemoperfusion: A New Treatment for Acute Drug Intoxication

Abstract
A resin-column hemoperfusion system was used to treat four patients with profound, life-threatening drug intoxication. The column contained 650 g of pyrogen-free resin, Amberlite XAD-2. The resin is uncharged and has a cross-linked, polystyrene macroreticular structure with particular surface attraction for high-molecular-weight, lipid-soluble molecules. Blood was pumped through the column at a flow rate of 300 ml per minute for three hours. Two patients had secobarbital, one a mixture of glutethimide-butabarbital-ethchlorvynol, and one amobarbital intoxication. In all patients the column clearances of these drugs were markedly superior to known clearances with hemodialysis. A transient, modest fall in blood platelet concentration followed hemoperfusion. No serious clinical toxic effects were noted. The resin-column hemoperfusion system was technically simpler, consistently more effective and clinically superior to hemodialysis.