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Higher efficacy of direct hemoperfusion using coated activated-charcoal column for disopyramide poisoning: A case report.

Abstract Cases of severe disopyramide poisoning are rare and few have been reported. We report a case in which activated-charcoal column hemoperfusion was dramatically effective for life-threatening disopyramide poisoning.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29245231
OWN - NLM
STAT- MEDLINE
DCOM- 20171221
LR  - 20171222
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 49
DP  - 2017 Dec
TI  - Higher efficacy of direct hemoperfusion using coated activated-charcoal column
      for disopyramide poisoning: A case report.
PG  - e8755
LID - 10.1097/MD.0000000000008755 [doi]
AB  - RATIONALE: Cases of severe disopyramide poisoning are rare and few have been
      reported. We report a case in which activated-charcoal column hemoperfusion was
      dramatically effective for life-threatening disopyramide poisoning. PATIENT
      CONCERNS: A teenage girl who had overdosed on disopyramide (total dose, 4950 mg) 
      was brought to our hospital. She was resuscitated from short period
      cardiopulmonary arrest and subsequently showed severe cardiogenic shock and
      ventricular arrhythmia. DIAGNOSES: Disopyramide poisoning (self-evident).
      INTERVENTIONS: As hemodynamics remained unstable after providing percutaneous
      cardiopulmonary support and intra-aortic balloon pumping, we attempted direct
      hemoperfusion using a coated activated-charcoal hemoperfusion column. OUTCOMES:
      Hemodynamics including electrocardiography and serum disopyramide concentration
      were dramatically improved, and the patient was ambulatory by hospital day 14.
      LESSONS: Because disopyramide has low molecular weight and a small distribution
      volume, blood purification is considered to be the most effective therapy. We
      selected direct hemoperfusion for relatively high protein-binding rate. In fact, 
      clinical status was dramatically improved, and the calculated half-life of the
      direct hemoperfusion phase was the shortest of all phases. In cases of severe or 
      life-threatening disopyramide poisoning, blood purification therapy including
      direct hemoperfusion using a coated activated-charcoal column should be
      performed.
FAU - Iguchi, Shigekazu
AU  - Iguchi S
AD  - aDepartment of Emergency and Critical Care MedicinebDepartment of Cardiology,
      Juntendo University Nerima HospitalcDepartment of Infectious Diseases, Tokyo
      Women's Medical University, Tokyo, Japan.
FAU - Yamaguchi, Naotaka
AU  - Yamaguchi N
FAU - Takami, Hiroki
AU  - Takami H
FAU - Komatsu, Takayuki
AU  - Komatsu T
FAU - Ookubo, Hirokazu
AU  - Ookubo H
FAU - Sekii, Hajime
AU  - Sekii H
FAU - Inoue, Kenji
AU  - Inoue K
FAU - Okazaki, Shinya
AU  - Okazaki S
FAU - Okai, Iwao
AU  - Okai I
FAU - Maruyama, Sonomi
AU  - Maruyama S
FAU - Nomura, Tomohisa
AU  - Nomura T
FAU - Sugita, Manabu
AU  - Sugita M
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Anti-Arrhythmia Agents)
RN  - 0 (Antidotes)
RN  - 16291-96-6 (Charcoal)
RN  - GFO928U8MQ (Disopyramide)
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Anti-Arrhythmia Agents/*poisoning
MH  - Antidotes/therapeutic use
MH  - Charcoal/therapeutic use
MH  - Disopyramide/*poisoning
MH  - Drug Overdose/*therapy
MH  - Female
MH  - Hemoperfusion/*methods
MH  - Humans
MH  - Treatment Outcome
PMC - PMC5728846
EDAT- 2017/12/17 06:00
MHDA- 2017/12/22 06:00
CRDT- 2017/12/17 06:00
PHST- 2017/12/17 06:00 [entrez]
PHST- 2017/12/17 06:00 [pubmed]
PHST- 2017/12/22 06:00 [medline]
AID - 10.1097/MD.0000000000008755 [doi]
AID - 00005792-201712080-00020 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(49):e8755. doi: 10.1097/MD.0000000000008755.