Management of Acute Clonidine Poisoning in Adults: The Role of Resin Hemoperfusion

Clonidine poisoning in adults is rare. An observational retrospective study including 102 adults with clonidine poisoning was conducted. 57 patients with relatively mild conditions were placed in the local emergency departments (EDs) for clinical observation, while the remaining 45 were transferred to the tertiary hospital for intensive treatment, of whom 9 were given supportive care only and 36 were given hemoperfusion (HP), as well as similar supportive treatment. The main symptoms of these cases were: sleepiness, dizziness, fatigue, headache, inarticulacy, tinnitus and dry mouth. Physical examination showed hypotension, bradycardia and shallow and slow breathing. Serum and urine clonidine concentrations were significantly elevated（24.4 ng/ml, 313.2 ng/ml, respectively）. All cases slowly returned to their baseline state over 48 to 96 hours, which is co-related with the drawn of serum clonidine level. HP showed more efficient in reducing the serum/urine clonidine level. Clonidine poisoning is a potentially serious condition, which involves multiple system injury, including persistent central nervous system depression, cardiovascular and inhalation inhibition, often requiring intensive treatment. Patients with mild presentations only needed to be monitored and treated with symptomatic support. Of critically ill patients, HP significantly reduced clonidine concentrations, which was effective and had few side effects.