Principles and operational parameters to optimize poison removal with extracorporeal treatments

Josée Bouchard, Darren M. Roberts, Louise Roy, Georges Ouellet, Brian S. Decker, Bruce A. Mueller, Simon Desmeules, Marc Ghannoum

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

A role for nephrologists in the management of a poisoned patient involves evaluating the indications for, and methods of, enhancing the elimination of a poison. Nephrologists are familiar with the various extracorporeal treatments (ECTRs) used in the management of impaired kidney function, and their respective advantages and disadvantages. However, these same skills and knowledge may not always be considered, or applicable, when prescribing ECTR for the treatment of a poisoned patient. Maximizing solute elimination is a key aim of such treatments, perhaps more so than in the treatment of uremia, because ECTR has the potential to reverse clinical toxicity and shorten the duration of poisoning. This manuscript reviews the various principles that govern poison elimination by ECTR (diffusion, convection, adsorption, and centrifugation) and how components of the ECTR can be adjusted to maximize clearance. Data supporting these recommendations will be presented, whenever available.

Original languageEnglish (US)
Pages (from-to)371-380
Number of pages10
JournalSeminars in Dialysis
Volume27
Issue number4
DOIs
StatePublished - 2014

ASJC Scopus subject areas

  • Nephrology

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