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Vergleichende in vitro Untersuchungen zur Hämoperfusion mit verschiedenen Adsorbentien

In vitro evaluation of adsorbents used in haemoperfusion

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Summary

The properties of six adsorbents for Haemoperfusion were investigated in vitro: Amberlite XAD-2; Amberlite XAD-4; Haemocol; collodion coated charcoal; albumine-collodion encapsulated charcoal and activated carbon fibers. Carbromal and diazepam are most quickly removed from aqueous solutions by Amberlite XAD-2 and XAD-4. Of the charcoal containing materials, Haemocol eliminates most rapidly carbromal and diazepam; while activated carbon fibers remove phenobarbital faster. When heparinized blood is perfused, a remarkable reduction in platelet count is observed. The drop is most pronounced with Amberlite XAD-2 and XAD-4, but even when using charcoal preparations the platelet depletion can reach 10% of the original number over 5 hours. Haemolysis is most pronounced with Amberlite XAD-2, XAD-4 and Haemocol. As the efficiency of the adsorbents towards the various drugs differ and as their adverse effects also vary, the decision for a particular material will have to be made according to the individual case.

Zusammenfassung

In der vorliegenden Arbeit werden die Adsorptionseigenschaften von 6 verschiedenen Materialien, die bei der Hämoperfusion eingesetzt werden in vitro geprüft: Amberlite XAD-2 und XAD-4, Haemocol, Collodium verkapselte Aktivkohle, Collodium verkapselte und Albumin beschichtete Aktivkohle und Aktivkohle-Hohlfaser. Carbromal wird am schnellsten eliminiert von Amberlite XAD-2 und XAD-4, ebenso Diazepam. Beim Vergleich der verschiedenen Kohlepräparate werden Carbromal und Diazepam am schnellsten von Haemocol aus der Lösung entfernt, Phenobarbital von Aktivkohle-Hohlfaser, wenn man eine 5-stündige Perfusion zu Grunde legt. Die gerinnungsphysiologischen und klinisch-chemischen Untersuchungen mit Hilfe von heparinisiertem Frischblut lassen schwerwiegende Nebenwirkungen erkennen. Die Abnahme der Thrombozyten ist am ausgeprägtesten bei Amberlite XAD-2 und XAD-4, sie ist aber auch bei den Kohlepräparationen nachweisbar: Nach 5stündiger Hämoperfusion ist ihre Zahl auf bis zu 10% des Ausgangswertes abgefallen. Die Hämolyse ist besonders stark bei Amberlite XAD-2 und XAD-4, sowie Haemocol. Die je nach Giftstoff unterschiedlich große Adsorption der geprüften Materialien und ihre verschieden stark ausgeprägten Nebenwirkungen erfordern nach unseren Ergebnissen einen der individuellen Situation des Patienten angepaßten Einsatz.

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Authors and Affiliations

  1. Institut für Klinische Chemie der Medizinischen Hochschule Hannover, Karl-Wiechert-Allee 9, D-3000, Hannover 61, Bundesrepublik Deutschland

    W. R. Külpmann & M. Oellerich

  2. Abteilung für Gastroenterologie u. Hepatologie des Departments Innere Medizin, Germany

    U. Blume & Ellen Schmidt

  3. Abteilung für Hämatologie des Departments Innere Medizin der Medizinischen Hochschule Hannover, Germany

    Monika Barthels

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  1. W. R. Külpmann
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  3. U. Blume
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Külpmann, W.R., Oellerich, M., Blume, U. et al. Vergleichende in vitro Untersuchungen zur Hämoperfusion mit verschiedenen Adsorbentien. Klin Wochenschr 56, 1171–1178 (1978). https://doi.org/10.1007/BF01476861

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