scholarly journals Assessment of Extracorporeal Treatments in Poisoning criteria for the decision of extracorporeal toxin removal in lithium poisoning

2019 ◽  
Vol 86 (3) ◽  
pp. 560-568 ◽  
Author(s):  
Dominique Vodovar ◽  
Sébastien Beaune ◽  
Jérôme Langrand ◽  
Eric Vicaut ◽  
Laurence Labat ◽  
...  
2016 ◽  
Vol 54 (8) ◽  
pp. 615-623 ◽  
Author(s):  
Dominique Vodovar ◽  
Souleiman El Balkhi ◽  
Emmanuel Curis ◽  
Nicolas Deye ◽  
Bruno Mégarbane

2021 ◽  
pp. 102490792110499
Author(s):  
Shuk Hang Chow ◽  
Chi Keung Chan

Background: Extracorporeal toxin removal is used for enhanced elimination in severe lithium poisoning. The Extracorporeal TReatments In Poisoning workgroup provides recommendations on the use of extracorporeal toxin removal in poisoning. Objectives: Our aim was to identify the pattern for using extracorporeal toxin removal in managing lithium poisoning in Hong Kong and compare the outcomes in extracorporeal toxin removal-treated patients and non-extracorporeal toxin removal-treated patients if indicated for treatment as defined by The Extracorporeal TReatments In Poisoning criteria. Methods: Lithium poisoning presented between year 2009 and 2019 in Hong Kong Poison Information Centre (HKPIC) database was categorized into extracorporeal toxin removal-treated group and non-extracorporeal toxin removal-treated group. Comparative analyses were performed. Results: Among 112 lithium-poisoned patients, 21% were treated with extracorporeal toxin removal. Larger proportion of patients had fulfilled at least one Extracorporeal TReatments In Poisoning criteria for extracorporeal toxin removal in the extracorporeal toxin removal-treated group (87% vs 18%, p < 0.005). The extracorporeal toxin removal-treat group patients were more commonly presented with impaired consciousness, seizure and dysrhythmia ( p < 0.05). They also got higher admission (3.62 mmol/L vs 2.18 mmol/L, p < 0.05) and peak (4.15 mmol/L vs 2.28 mmol/L, p < 0.05) serum lithium concentrations, as well as a significantly higher serum creatinine concentration upon presentation (263.74 µmol/L vs 98.66 µmol/L, p < 0.05). Extracorporeal toxin removal-treat group patients more frequently had a severe poisoning outcome (91.3% vs 9%, p < 0.05) and developed complications (69.6% vs 13.5%, p < 0.05). Logistic regression identified seizure, peak serum lithium concentration, and serum creatinine concentration upon presentation as risk factors for severe poisoning outcome. In subgroup analysis on patients with at least one indication for extracorporeal toxin removal as defined by Extracorporeal TReatments In Poisoning criteria, the proportion of severe poisoning remained higher in the extracorporeal toxin removal-treated group (90% vs 43.7%, p < 0.05). Complication rate was not significantly different between the two groups. Conclusion: Clinically severe lithium poisoning patients were treated with extracorporeal toxin removal in Hong Kong. Extracorporeal TReatments In Poisoning criteria can serve as a reference in considering extracorporeal toxin removal treatment for lithium poisoning patients. Nevertheless, Extracorporeal TReatments In Poisoning criteria recommend more extracorporeal toxin removal treatment than it was actually done. Lithium poisoning patients with positive Extracorporeal TReatments In Poisoning criteria have been managed without extracorporeal toxin removal. No statistically significant adverse outcome was observed in these cases.


Membranes ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 364
Author(s):  
Marcelo Ayllon ◽  
Gamid Abatchev ◽  
Andrew Bogard ◽  
Rosey Whiting ◽  
Sarah E. Hobdey ◽  
...  

The need for alternatives to antibiotics in the fight against infectious diseases has inspired scientists to focus on antivirulence factors instead of the microorganisms themselves. In this respect, prior work indicates that tiny, enclosed bilayer lipid membranes (liposomes) have the potential to compete with cellular targets for toxin binding, hence preventing their biological attack and aiding with their clearance. The effectiveness of liposomes as decoy targets depends on their availability in the host and how rapidly they are cleared from the circulation. Although liposome PEGylation may improve their circulation time, little is known about how such a modification influences their interactions with antivirulence factors. To fill this gap in knowledge, we investigated regular and long-circulating liposomes for their ability to prevent in vitro red blood cell hemolysis induced by two potent lytic toxins, lysenin and streptolysin O. Our explorations indicate that both regular and long-circulating liposomes are capable of similarly preventing lysis induced by streptolysin O. In contrast, PEGylation reduced the effectiveness against lysenin-induced hemolysis and altered binding dynamics. These results suggest that toxin removal by long-circulating liposomes is feasible, yet dependent on the particular virulence factor under scrutiny.


ASAIO Journal ◽  
2005 ◽  
Vol 51 (2) ◽  
pp. 7A
Author(s):  
Stefan A Safta ◽  
R H Miller ◽  
J F Patzer
Keyword(s):  

1967 ◽  
Vol 13 (6) ◽  
pp. 629-633 ◽  
Author(s):  
E. B. Lillehoj ◽  
A. Ciegler ◽  
H. H. Hall

Aflatoxin G1was removed from liquid cultures by growing and resting cells of Flavobacterium aurantiacum NRRL B-184. In inoculated culture media containing toxin levels of 7.5 p.p.m. and above, there was a protracted growth lag which was subsequently overcome; toxin removal then occurred, concomitant with growth. Only a few cells demonstrated aberrant morphological forms when cultured in the presence of aflatoxin G1. A comparison of the effects of aflatoxin G1with B1on growth and morphology showed that B1was distinctly more toxic. Three hundred and thirty micrograms of aflatoxin G1was removed per 1 × 1013resting cells during a 4-hour incubation period. Preincubation of resting cells with aflatoxin B1did not interfere with subsequent uptake of G1.


1966 ◽  
Vol 4 (26) ◽  
pp. 103-104

In 1949 Cade1 introduced lithium into psychiatric use in Australia demonstrating its efficacy in the treatment of manic excitement. Unfortunately the drug almost immediately acquired a sinister reputation in the United States when its use as a salt substitute in cardiac patients caused a number of deaths from lithium poisoning.2 In Europe the advent of chlorpromazine and reserpine in the early 1950’s delayed the development of lithium; but in the last few years interest has revived as knowledge of fluid balance and mineral metabolism in affective disorders has increased.3


2021 ◽  
Author(s):  
Christine Bacal ◽  
James Wainaina Maina ◽  
Harshal Nandurkar ◽  
Maryam Khaleel ◽  
Rosanne Marieke Guijt ◽  
...  

Blood apheresis technologies are crucial during blood donation and toxin removal. Current purification methods such as leukacytapheresis, erythrocytapheresis, thrombocytapheresis and plasmapheresis primarily rely on centrifugation and membrane filtration to separate...


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