Acute Disease ; Animals ; Charcoal ; therapeutic use ; Enema ; Milk ; Paraquat ; toxicity

Aconitine ; poisoning ; Aconitum ; chemistry ; poisoning ; Cardiopulmonary Resuscitation ; Charcoal ; therapeutic use ; Female ; Hemoperfusion ; Humans ; Male ; Middle Aged ; Poisoning ; drug therapy

Adolescent ; Adult ; Aged ; Charcoal ; administration & dosage ; therapeutic use ; Enema ; Female ; Gastric Lavage ; Humans ; Male ; Middle Aged ; Organophosphate Poisoning ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVEIn China, with the development of public health and medical treatment, accident became the first cause of death of children aged form 1 to 14 years, and poisoning became one of the main causes. The present study was conducted to investigate the efficacy of hemoperfusion (HP) on poisoning, and the pharmacokinetics of the poison during and after HP. The study was also to observe the effect of HP on blood cell and blood biochemistry, blood flow and dosage of heparin during HP in children.

METHODSThirty-five children with acute poisoning (including 26 boys and 9 girls aged from 10 months to 13 years, mean 3.35 +/- 2.50 years) were treated with HP for one to three times. Among them 12 children were treated with HP for two times and 4 children for three times. Two ml blood samples of 6 children with Fluoroacetamide (FAM) poisoning and 10 children with Tetramine (TET) poisoning were collected. The concentration of poison was measured by gas chromatography (GC).

RESULTSThe poisoning symptoms of all cases were relieved or alleviated obviously. In the end, 27 (77%) cases recovered and 6 (17%) cases improved, while 2 (6%) cases died of multi-organ failure (MOF). Clinical symptom happened again 6 - 24 hours after HP in 1 case with FAM poisoning and 3 cases with TET whose clinical symptoms were relieved during HP. The PLT, RBC counts and Hb decreased significantly after HP compared with pre-HP (P < 0.05), while WBC, alanine aminotransferase (ALT), aspartate aminotransferase (AST), reatine kinase (CK), blood urea nitrogen (BUN), creatinine (CRE), Creatine kinase isoenzymes (CK-MB), total protein (TP), albumin (ALB) and globulim (GLO) after HP did not significantly change (P > 0.05). The FAM concentration was significantly reduced (P < 0.030). The concentration of TET in the poisoned children also significantly decreased with the treatment (P = 0.001). The cleaning efficacy of HP was higher during the first hour than that during the second hour of HP. The concentration of poison rose again 2 - 6 hours after HP in 1 case with FAM poisoning and 3 cases with TET poisoning, but the level was lower compared with pre-HP level. The t(1/2) of FAM and TET with and without HP was (2.40 +/- 0.66) h, (15.60 +/- 8.22) h, (4.10 +/- 1.66) h and (67.01 +/- 48.42) h, respectively. The first dose of heparin was (0.54 +/- 0.15) mg/kg; then (0.20 +/- 0.06) mg/kg was added for every 30 minutes. The velocity of blood flow was (4.39 +/- 0.99) ml/min.

CONCLUSIONSThe t(1/2) of the poison was shortened, and the poison clearing was accelerated by HP. The HP is a safe and effective therapy in children. The concentration of poison in some patient may rise again 2 to 6 hours after HP temporarily. The charcoal HP cannot remove the poison that conjugated with plasma albumin and globulin. The charcoal HP can cause temporary reduction of platelet and erythrocyte. The dosage of heparin used in children was lower than that in adult.

Blood Urea Nitrogen ; Charcoal ; therapeutic use ; Child, Preschool ; China ; Creatinine ; blood ; Female ; Hemoperfusion ; methods ; Humans ; Infant ; Male ; Multiple Organ Failure ; blood ; therapy ; Neonatology ; Poisoning ; blood ; therapy

OBJECTIVEIn the past the mortality and sequelae rate of the patients with severe fluoroacetamide (FAM) poisoning treated only with traditional remedies was high. During the recent ten years the authors treated children with severe FAM poisoning with charcoal hemoperfusion (HP) and achieved better results. However evidence was not sufficient to show that reduced mortality and sequelae rates were obtained from HP without traditional treatment because of lack of prospective randomized, controlled clinical studies. Thus, a dog model for FAM poisoning was designed in order to study the therapeutic effect, high-efficiency time of HP, the time of tissue-poisoning to release after HP, and to investigate the toxicokinetics of the poison in the course of treatment and after HP.

METHODFourteen dogs were given intraperitoneal FAM at a dose of 0.3 mg/kg body weight. HP was performed on 9 poisoned dogs for 30 - 120 minutes post intoxication. Each procedure lasted for 4 hours. Blood samples of the 9 poisoned dogs were collected before HP and 30, 60, 90, 120, 180, 240 minutes during HP and 2, 6, 24 hours after HP. Blood plasma was separated from blood samples and stored at -20 degrees C. The concentration of the poison was measured by gas chromatography (GC). The clinical symptoms of all the dogs were observed for one day.

RESULTSThe FAM concentration (ng/ml) of blood samples in poisoned dogs before HP, and 60, 120, 180, 240 minutes during HP were 230.11 +/- 52.48, 184.56 +/- 62.57, 141.00 +/- 44.83, 126.78 +/- 61.04, 113.11 +/- 54.65 respectively. The differences were significant (chi(2) = 31.978, P < 0.0005). The dispersion count between pre-HP and HP for 1 was 45.55, between 1 h and 2 h was 43.56, between 2 h and 3 h was 14.22 and between 3 h and 4 h was 13.67. The values of FAM had declined by 38.7%, 45.0% and 50.8% respectively at 2 h, 3 h, 4 h of HP compared with pre-HP. The rate of cleaning efficacy of FAM of every hour during HP were 19.79%, 23.6%, 10.09% and 10.78% respectively during HP 1, 2, 3, 4 h. The cleaning efficacy of HP was high within 2 hours during HP. The concentration of FAM slightly rose again 6 h after HP. The level of FAM had declined at 24 hour after HP when compared with pre-HP level. The reduction rate of FAM level for every hour during HP was higher than that after HP (12.71% vs 0.27% - 2.22%). The t(1/2) of FAM with and without HP were (4.50 +/- 1.20) h and (49.60 +/- 10.56) h. All the 5 poisoned dogs not treated with HP died. However 6 poisoned dogs treated with HP kept alive after HP. Three dogs had frequent seizures again 4h after HP. After HP the charcoal container was washed by 0.9% saline and FAM could not be detected in the douche.

CONCLUSIONSCharcoal HP was an effective treatment for severe FAM poisoning. T(1/2) of the poison was shortened, and the poison clearing rate was accelerated by HP. The high-efficiency time of HP was 2 - 2.5 h. Activated charcoal can adsorb the poison vigorously, and return of blood to the body after HP by using 0.9% saline was feasible and safe.

Animals ; Charcoal ; therapeutic use ; Dogs ; Fluoroacetates ; poisoning ; Hemoperfusion ; methods ; Metabolic Clearance Rate ; Poisoning ; metabolism ; therapy ; Poisons ; toxicity ; Seizures ; chemically induced ; Treatment Outcome

OBJECTIVE: To observe rule of medicine concentration of blood and the last concentration that through hemoperfusion after poisoned by acephate. METHODS: Utilizeng the patient annual bonus venous blood in hospital emergency room, the content of acephate in plasma was analyzed by gas chromatography. RESULTS: After hemoperfusion, the concentration of acephate showed a rapid drop and the characteristic that the concentration drops quicker if medicine concentration of blood before hemoperfusion is higher. CONCLUSION Hemoperfusion is able to rapidly reduce the concentration of acephate in blood, its speed is determined by initial concentration and the beginning time of hemoperfusion etc.
Acute Disease ; Adult ; Charcoal/therapeutic use* ; Chromatography, Gas ; Coma/therapy* ; Emergency Service, Hospital ; Female ; Hemoperfusion ; Humans ; Male ; Middle Aged ; Organothiophosphorus Compounds/poisoning* ; Phosphoramides ; Poisoning/therapy* ; Time Factors

OBJECTIVETo evaluate the beneficial effect of intraperitoneally applied mitomycin bound to activated carbon particles (MMC-CH) in the prevention and treatment of intraabdominal recurrence after curative surgery for gastric cancer.

METHODSOne hundred and twenty-four patients with radically resected gastric cancer infiltrating the serosal surface were randomly divided into group receiving 50 mg mitomycin bound to a solution of 375 mg carbon adsorbent intraperitoneally before closure of the abdominal wound (n = 62) and a control group (n = 62). The patients with MMC-CH and the control group were received systemic chemotherapy 3 months or 3 weeks after operation respectively. The postoperative recurrence-free survival was evaluated to analyze the benefits of this treatment.

RESULTSAfter observation for 8 months (range, 2 - 65). The 3-, 5-year postoperative recurrence-free survival rates were significantly higher in the MMC-CH group (70.16%, 44.51%) than in the control group (27.09%, 14.45%), P < 0.01.

CONCLUSIONAdjuvant intraperitoneal chemotherapy of gastric cancer by mitomycin bound to activated carbon particles is effected by an increased postoperative recurrence-free survival rate.

Antibiotics, Antineoplastic ; administration & dosage ; Antineoplastic Agents ; administration & dosage ; therapeutic use ; Charcoal ; administration & dosage ; Chemotherapy, Cancer, Regional Perfusion ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Neoplasm Recurrence, Local ; prevention & control ; Peritoneal Cavity ; Prognosis ; Prospective Studies ; Stomach Neoplasms ; drug therapy ; pathology ; Survival Analysis ; Treatment Outcome