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Hämoperfusion durch verkapselte Aktivkohle zur Therapie exogener und endogener Intoxikationen

Hemoperfusion by means of encapsuled charcoal for the treatment of exogenous and endogenous intoxications

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Summary

The method developed by Chang for using in collodion and albumin encapsuled charcoal as artificial cells for hemoperfusion has been studied in vitro. The capacity for the absorption of more or less dialysable exogenous substances (barbiturate, Diazepam, Parathion) and an endogenous toxic metabolite (p-hydroxyphenyl acetic acid) has been examined. With the absorption unit one can eliminate 80 to 90 per cent of the initial concentration of barbiturate, Diazepam and p-hydroxyphenyl acetic acid in about 90 min, of Parathion about 50 per cent in the same time, whereas bromide and ammonia are not absorbed. Attempts to avoid regional heparinisation by the incorporation of heparin into the capsule of charcoal granules were not successful.

Assuming correct preparation of the hemoperfusion system, observance of steril precoutions and regional heparinisation, the use of the “detoxication shunt” is a promising means in the treatment of severe exogenous and endogenous intoxications which are not accessible by conventional therapeutic means.

Zusammenfassung

Die von Chang entwickelte Methode, artefizielle Zellen — in Kollodium und Albumin verkapselte Aktivkohle — zur Hämoperfusion einzusetzen, wurde in vitro studiert. Geprüft wurde die Kapazität zur Adsorption von schlecht wie gut dialysablen Substanzen (Barbiturate, Diazepam, Parathion) und einem endogen toxischen Metaboliten (p-Hydroxyphenylessigsäure). — Mit der Adsorptions-Einheit lassen sich in 90 min 80–90% der Ausgangskonzentrationen von Barbiturat, Diazepam und p-Hydroxyphenylacetat eliminieren, von Parathion etwa 50%, Bromid und Ammoniak werden nicht adsorbiert. Versuche, durch den Einbau von Heparin in die Hülle der Kohlegranula die regionale Heparinisierung unnötig zu machen, waren erfolglos.

Bei sachgemäßer Herstellung des Shunt-Systems, Einhaltung steriler Kautelen und regionaler Heparinisierung ist der Einsatz des „Entgiftungs-Shunts“ eine vielversprechende Möglichkeit zur Therapie schwerer exogener und endogener Intoxikationen, die einer konventionellen Therapie nicht zugänglich sind.

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Authors and Affiliations

  1. Aus den Abteilungen für Gastroenterologie und Hämatologie des Departments Innere Medizin, Medizinische Hochschule Hannover, Germany

    P. Lesch, U. Blume, G. Scheibe, P. Sussmann, F. W. Schmidt, M. Bartels & S. Okonek

  2. II. Medizinischen Klinik der Universität Mainz, Germany

    P. Lesch, U. Blume, G. Scheibe, P. Sussmann, F. W. Schmidt, M. Bartels & S. Okonek

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  1. P. Lesch
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  2. U. Blume
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  3. G. Scheibe
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  4. P. Sussmann
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  5. F. W. Schmidt
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  6. M. Bartels
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  7. S. Okonek
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Lesch, P., Blume, U., Scheibe, G. et al. Hämoperfusion durch verkapselte Aktivkohle zur Therapie exogener und endogener Intoxikationen. Klin Wochenschr 54, 509–516 (1976). https://doi.org/10.1007/BF01468971

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