Sedative Overdosage and the Role of Hemodialysis

Abstract

Introduction Severe overdosage with sedatives continues to present a serious problem in management. In New York since 1954, sedatives were ranked as the third most common method of committing suicide.¹ In former years the patient rendered comatose by these drugs could be treated only with symptomatic measures and the maintenance of vital functions.² Hemodialysis with the artificial kidney now provides a specific method for removal of the toxic agent.³ Schreiner⁴ has outlined the properties which make drugs suitable for removal by dialysis and reviewed the indications for use of this procedure in intoxicated patients. The latter include: (a) ingestion of a known fatal dose of drug, (b) blood levels in the lethal range, (c) presence of a coexisting or complicating disease, and (d) progressive deepening of anesthesia with clinical deterioration or failure to improve after a period of observation. Difficulties arise, however, when more than one