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At least 19 recordsLinked to original sources
PubMed1982

Hemoperfusion and DNA synthesis in the rat liver. Part II: the effect of hemoperfusion on DNA synthesis in the rat liver undergoing compensatory hyperplasia after partial hepatectomy.

An investigation has been made into whether hemoperfusion over activated charcoal effects the rate of DNA synthesis in the rat liver undergoing compensatory hyperplasia. Hemoperfusion was performed in the unrestrained and conscious rat, thus minimizing any possible effects of stress and eliminating exposure to anesthetic agents. The results demonstrate that hemoperfusion over Norit RBX1 charcoal does not influence the liver to undergo compensatory hyperplasia following partial hepatectomy when hemoperfusion is performed immediately after hepatic injury, and that liver mass, function, and fat content consequent upon partial hepatectomy are also not influenced.

Animals↗
PubMed1982

Hemoperfusion and DNA synthesis in the rat liver. Part I: the effect of hemoperfusion on the rate of DNA synthesis.

An investigation has been made into whether charcoal hemoperfusion stimulates a hyperplastic response in the liver of the normal rat. Animals underwent hemoperfusion over Norit RBX1 (Strathclyde, Glasgow, U.K.) charcoal granules using a technique which allowed perfusion in the unrestrained and conscious state. Controls consisted of animals subjected to perfusion through empty columns and animals cannulated only. Body weight, liver weight, function, and DNA synthesis were recorded at various times after completion of perfusion and control procedures. The results indicated that charcoal hemoperfusion did not stimulate a hyperplastic response in the liver of the normal rat following perfusion, and did not produce marked changes in body weight, liver weight, and function.

Alanine Transaminase↗
PubMed1992

Reduction of ischemia with a new flow-adjustable hemoperfusion pump during coronary angioplasty. The Coronary Hemoperfusion Ischemia Prevention Study (CHIPS) Investigators.

A new flow-adjustable pump for coronary hemoperfusion to prevent ischemia during routine coronary angioplasty was evaluated in a multicenter prospective study of 110 patients. The protocol included patients who had angina or ST segment elevation during a control balloon inflation of less than or equal to 3 min. Hemoperfusion was performed by means of a new large lumen angioplasty catheter utilizing the patient's renal vein or femoral artery blood. Vessels perfused were the left anterior descending coronary artery (n = 74), right coronary artery (n = 39), left circumflex artery (n = 9) and coronary vein grafts (n = 15). Mean (+/- SD) perfusion flow was 41 +/- 9 ml/min (range 17 to 70); mean perfusion time was 9.3 +/- 4 min (median 8.5, range 2 to 30). Chest pain score (0 to 4) decreased from 2.9 +/- 1 to 1.4 +/- 1 during hemoperfusion (p less than 0.001); ST segment elevation score (0 to 4) decreased from 2.6 +/- 1 to 0.7 +/- 1 (p less than 0.005) and inflation time increased from 1.3 +/- 0.9 to 7 +/- 4 min, (p less than 0.001). At least a 50% increase in tolerated inflation time was obtained in 104 patients (95%). Free plasma hemoglobin and creatine kinase levels did not increase significantly over baseline values. Angioplasty was successful in 107 patients (97%), with mean stenosis reduced from 87 +/- 11% to 20 +/- 17%; 3 patients had urgent bypass surgery, 2 (1.8%) had a myocardial infarction (1 Q wave, 1 non-Q wave) and 2 (1.8%) died later in the hospital of probable noncoronary causes.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

Hemoperfusion during coronary angioplasty: first European experience with a new hemoperfusion pump.

Hemolysis tests with fresh human blood were performed in vitro with a new 5 ml, piston-type hemoperfusion pump, designed to prevent myocardial ischemia during coronary angioplasty. Despite driving pressures greater than 3 atmospheres, shear stress greater than 200 Pa, turbulent pump flow, and the presence of occlusive valves, hemolysis proved to be minimal. This effect is explained by the short amount of time that blood is subjected to mechanical forces that cause hemolysis in the system and by the small volumes of blood involved. During clinical application of the system, angina pectoris, electrocardiographic changes, and systemic blood pressure were used as parameters for myocardial ischemia. There was an effective reduction of ischemia during prolonged (10 min) balloon inflation, demonstrated by the absence of angina, minimal electrocardiographic changes, and normal blood pressure. In addition, the system proved to be safe and effective during high-risk angioplasty.

Adult↗
PubMed1989

[Polymeric sorbents for hemoperfusion. Preparation, structure and adsorption properties of chemically modified polymer sorbents for hemoperfusion].

In this work the way of chemical modification of macroporous polymer sorbents with a styrene-divinyl-benzene++ structure was presented. Their modification with amino acids leads to improvement of hemocompatibility of sorbents and to sorption magnification, particularly of hydrophilic polysorbates. In the work the full physical chemical characteristics of the received products was given and their sorption properties in the relation to urea, vitamin B12 and substances from phosphor-organic pesticides group as well as from barbituric acid derivatives were designated.

Biocompatible Materials↗
PubMed1995

Critical, acutely poisoned patients treated with continuous arteriovenous hemoperfusion in the emergency department.

STUDY OBJECTIVE: To investigate the efficiency of a new non-pump hemoperfusion technique, continuous arteriovenous hemoperfusion, in the treatment of critical, acutely poisoned patients. SETTING: Emergency department of a general hospital. PARTICIPANTS: Acutely poisoned patients who failed to respond to intensive supportive treatment and needed hemoperfusion therapy. INTERVENTIONS: All patients received continuous arteriovenous hemoperfusion therapy for 4 to 8 hours. Toxicant clearances were determined by obtaining serial theophylline and phenobarbital levels every 2 hours before, during, and after continuous arteriovenous hemoperfusion. Platelet counts, whole-blood activated clotting time, and vital signs were monitored. RESULTS: The clinical condition of these patients improved rapidly after continuous arteriovenous hemoperfusion was started. The treatments were performed easily, and no significant complications occurred. The clearances of theophylline and phenobarbital were 192.79 +/- 1.55 mL/min and 290.25 +/- 25.33 mL/min, respectively, similar to those of conventional hemoperfusion. CONCLUSION: Continuous arteriovenous hemoperfusion is a simple, safe, effective, and less costly alternative to conventional hemoperfusion, especially in the EDs of hospitals without hemoperfusion facilities immediately available.

Acute Disease↗
PubMed1990

Efficacy of single or repeated hemoperfusion in a canine model of paraquat poisoning.

Although hemoperfusion has been used to treat paraquat poisoning, its efficacy has been widely debated. This study examines the kinetic and pathologic correlates of paraquat toxicity and hemoperfusion and the efficacy of hemoperfusion in four groups of four dogs. This species was chosen because the kinetics and toxicity of paraquat are similar to those in the human. All dogs given a lethal dose of paraquat dichloride producing 100% mortality as a 2-hr infusion (7.48 mg of paraquat ion per kg) developed the typical clinical, laboratory and pathologic features of paraquat toxicity and died within 5 to 7 days. All dogs given paraquat and hemoperfused for 8 hr daily, beginning at 12 hr, died within 3 to 6 days. Two of four dogs which were hemoperfused once, beginning at 2 hr, survived. One dog in the repeated hemoperfusion only group died from blood loss. Negligible amounts of paraquat (0.4-2.0% of the total dose) were adsorbed during repeated hemoperfusion because of extensive excretion of paraquat in urine and sequestration in peripheral tissues from which redistribution was slow. The efficacy in the single early hemoperfusion group can be attributed to removal of 25% of the dose by the procedure in the two survivors. We conclude that single hemoperfusion may have some clinical application in patients who present within a few hours of the ingestion and have not ingested a dose of paraquat that is multiples of the lethal dose producing 100% mortality. It is doubtful if there is any role for repeated hemoperfusion.

Absorption↗
PubMed1999

Hemoperfusion study with carbamazepine in vitro.

Sorption efficacy of active charcoal, Amberlite XAD-2 and Amberlite XAD-4 in hemoperfusion with carbamazepine was investigated in vitro. Authors carried out 15 hemoperfusions with carbamazepine in a closed system using the above mentioned sorbents; The perfusion solution used was 3,000 ml of 0.9% NaCl. The carbamazepine concentration in the solution was 52.5+/-3.0 mg/L. In addition, two in vitro hemoperfusions with carbamazepine using Amberlite XAD-2 sorbent and 1.500 ml of human plasma as a perfusion solution, were also performed. The concentration of carbamazepine in plasma was 50.4+/-1.2 mg/L. Individual hemoperfusions lasted 5 hours. Zero values of carbamazepine were achieved after 120 min of Amberlite XAD-2 or Amberlite XAD-4 hemoperfusion in 0.9% NaCl and after 240 min of hemoperfusion in human plasma. The results gathered suggest that the most effective in vitro hemoperfusion with carbamazepine was obtained with Amberlite XAD-2 or Amberlite XAD-4 and the least effective was with active charcoal. The authors recommend the use of hemoperfusion with Amberlite XAD-2 or Amberlite XAD-4 for acute intoxications with carbamazepine in humans. In addition, authors successfully performed 5-hour hemoperfusion using Amberlite XAD-4 in vivo, in an 18-year-old girl, who suffered from acute carbamazepine intoxication after a suicidal attempt. This treatment led to the rapid survival.

Adolescent↗
PubMed2004

[The clinical efficacy of hemoperfusion in treatment of drug poisoning].

OBJECTIVE: To investigate the ability of hemoperfusion to remove some drugs or toxin from the body and its clinical efficacy. METHODS: Sixty-nine cases of poisoning due to tetramine or other drugs poisoning in our hospital between July 1990 and December 2003 were studied. Thirty-four patients among them received conventional treatment (including early gastric lavage, hepatoprotection, diuresis or respiratory support), and the remaining were given conventional treatment and hemoperfusion. Toxin concentration changes in blood before and after hemoperfusion, survival rate, time from come onset to regaining consciousness and convulsion termination and duration of clinical course were compared. RESULTS: In the hemoperfusion group, three patients died, the survival rate was 91.4%, whereas in the non-hemoperfusion group, the survival rate was 85.3% (P > 0.05). Meanwhile the clinical course was markedly shortened in the hemoperfusion group (P < 0.05). The time from coma onset to regaining consciousness and convulsion termination in the hemoperfusion group was significantly shorter than that in the non-hemoperfusion group. The clearance rate was different for different poisons, among them the benzodiazepines had an excellent clearance. CONCLUSIONS: Hemoperfusion could adsorb from blood a different amount of poisons. There is obvious efficacy in shortening clinical course and reducing complications. It could possibly raise survival rate in serious poisoning.

Adolescent↗
PubMed1981

First experience with clinical use of an original hemoperfusion system.

1. The authors present their experience with the use of an original charcoal hemoperfusion system Hemosorb in clinical application, in 9 patients with a heavy metabolic disturbance (failure of the liver and kidney) and after an intoxication with drugs. 2. In two patients the consciousness was remarkably recovered and in one patient it was improved already in the course of the hemoperfusion process, in further two cases the consciousness was recovered in short time after the Hemosorb was used, 7 were completely healed. 3. During the hemoperfusion with Hemosorb there were no symptoms of bad tolerance and no complications except for temporary pyretic reaction in one case. In unique cases manifestations of an enhanced bleeding occurred at the end of the long-term process, which were, however, rather easily corrected. The drop of thrombocytes was essentially reasonable and their restriction after the hemoperfusion was good. 4. Out of metabolic parameters of interest, in the patients with the heavy metabolic failure the drop of total phenol substances, uric acid and creatinine in the blood serum were observed at first stages of the hemoperfusion. The clearance of the total phenol substances and creatinine in the hemoperfusion system was ever rather high. 5. In a patient intoxicated with drugs, there was a remarkable drop of the metaqualone in the blood serum in the course of the hemoperfusion with Hemosorb; the clearance of this compound in the hemoperfusion system was still high after 4 hrs. 6. The first experiences with the clinical application of a new, original hemoperfusion system demonstrated its non-harmful character and biocompatibility as well as clinical, metabolic and toxicologic efficiency.

Child↗
PubMed1980

Resin hemoperfusion in ethychlorvynol overdose.

An 18-yr-old male with a severe ethchlorvynol (ECV) overdose was treated with Amberlite XAD-4 resin hemoperfusion. Plasma ECV concentration declined 33% during a 3.5-hr hemoperfusion, but rebounded substantially, peaking 6 hr later. It was estimated that 16% of ECV in the body was removed. Following hemoperfusion, plasma ECV concentrations declined linearly at a rate of 13 mg/1/day. Hemoperfusion clearance was estimated by both the traditional method, using extraction ratios across the column and column blood flow (Cl = 270 ml/min), and an alternative method, using blood concentrations during hemoperfusion and recovery of drug from the resin (Cl = 184 ml/min). The latter may provide a better estimate of hemoperfusion clearance because it is not subject to error (which can be substantial) in measurement of column blood flow. The resin completely extracted ECV from plasma, resulting in a rate of elimination 10 times that expected from endogenous processes. To aid in kinetic analysis, blood:plasma partition and protein binding of ECV in 3 normal subjects were also examined. Blood:plasma ratio averaged 0.88 +/- 0.04 and fraction free in plasma, 0.38 +/- 0.02; neither changed as a function of blood concentration between 27 and 108 mg/1. Our data indicate that removal of ECV from the overdosed patient by hemoperfusion is limited by extensive distribution in and slow redistribution from body tissues, but because of the extremely slow rate of removal by the body and the severe nature of the ECV overdose, Amberlite XAD-4 hemoperfusion may be clinically useful.

Adolescent↗
PubMed1978

Solute, amino acid, and hormone changes with coated charcoal hemoperfusion in uremia.

This investigation assesses the effect of two-hour activated charcoal hemoperfusion using a column containing 300 g of acrylic hydrogel-coated activated charcoal either alone or combined with hemodialysis on small and "middle molecule" removal in uremic patients. Comparison was made with standard five-hour hemodialysis. Two patients with dialysis encephalopathy were treated with four-hour combined hemoperfusion/hemodialysis without beneficial clinical effects. Hemoperfusion increased the clearance rates of creatinine and urate when combined with dialysis. Hemoperfusion alone removed 1.3 +/- 0.6 g (mean +/- SD) of creatinine and 0.6 +/- 0.2 g of urate, while combined hemoperfusion/hemodialysis removed 1.7 +/- 0.6 g of creatinine and 1.0 +/- 0.5 g of urate in a two-hour period. Both treatment schedules removed less solute than standard five-hour hemodialysis but were associated with comparable "middle molecule" removal. Hemoperfusion accounted for additional amino acid removal when combined with hemodialysis, while hemoperfusion alone produced significant reduction only in the amino acid cystine. Changes in the hormones thyroxine, triiodothyronine, human growth hormone, and insulin were noted during the procedures. Acceptable falls in platelet counts and fibrinogen occurred with hemoperfusion. Coated charcoal hemoperfusion may prove to have a role in the management of uremic patients, although the acrylic hydrogel-coated charcoal hemoperfusion device requires combination with techniques allowing fluid and electrolyte removal.

Amino Acids↗
PubMed1997

Prolongation of discordant heart xenograft survival after liver hemoperfusion: role of nonparenchymal liver cells.

In the discordant guinea pig (GP)-to-rat combination, heart xenografts are hyperacutely rejected. The aim of the present study was to demonstrate that a donor-species-specific extracorporeal liver hemoperfusion can prolong survival of discordant heart xenografts and to specify the role of non-parenchymal cells. GP hearts were grafted into Brown Norway rats (group 1) In group 2, heart xenografting was carried out immediately after a 15-min GP hemoperfusion. In group 3, Kupffer cells of the GP liver were blockaged by intravenous injection of dextran sulfate (4 mg/100 g) 30 min before hemoperfusion. In group 4, Kupffer cells of the liver were activated by intravenous injection of muramyl dipeptide (MDP; 500 micrograms/250 g) 24 h before hemoperfusion. Lymphocytotoxic antibodies were detected according to a complement-dependent antibody assay. A donor-specific liver hemoperfusion can delay hyperacute rejection of heart xenografts (67.6 +/- 47.1 min in group 2 versus 8.0 +/- 2.4 min in group 1; p < 0.01) and reduce the level of lymphocytotoxic antibodies. Deposits of immunoglobulins and complement were significant on the hemoperfused liver and moderate on the transplanted heart. In group 3, after blockade of Kupffer cells with dextran, heart xenograft survival was less prolonged (31.8 +/- 8.2 min) and the decrease in antibody levels was not significant and associated with moderate deposits of immunoglobulins and complement on the hemoperfused liver and significant deposits on heart xenografts. In group 4, after stimulation of Kupffer cells by MDP, a significant decrease in antibody levels was present, and significant deposits were observed. These results show that donor-specific liver hemoperfusion can prolong the survival of discordant heart xenografts and support the hypothesis that nonparenchymal liver cells play a major role by absorption of preformed antibodies and complement.

Animals↗
PubMed1987

Repeated hemoperfusion and continuous arteriovenous hemofiltration in a paraquat poisoned patient.

Prompt hemodialysis or hemoperfusion can be of value during the first 24 hours after paraquat ingestion particularly when the patient has developed acute renal failure. However, many cases of paraquat poisoning occur in areas where hemoperfusion facilities are unavailable. In contrast, continuous arteriovenous hemofiltration (CAVH) could be instituted easily. We have measured the removal of paraquat from the body by CAVH in a 46 year old male cane farmer who ingested 70 ml, 20% paraquat and died twelve days later from pulmonary fibrosis. Renal failure developed rapidly. Concentrations of paraquat were measured by an indirect competitive ELISA using a murine paraquat monoclonal IgG antibody. Hemoperfusion was performed daily for five days, beginning 78 hours post-ingestion. By 180 hours, when the patient was in respiratory failure, hemoperfusion was replaced with CAVH which was continued for 46 hours. During this time interval, 1.1 mg paraquat was recovered in the hemofiltrate and 1.56 mg paraquat in the urine. The extraction of paraquat by the hemofilter was close to 100%. The plasma clearance of paraquat across the hemofilter was 6.1 ml/min and the renal clearance was 8.2 ml/min. The mean hemoperfusion clearance of paraquat was 50 ml/min and the total amount of paraquat removed by the 34 hours of hemoperfusion was 9 mg. Because of the relative ease with which CAVH can be performed, its low cost, compared to that of hemoperfusion or hemodialysis, and the continuous nature of the procedure, CAVH may be worth considering in paraquat poisoning. It could be used particularly in those patients who have developed renal failure or while patients are being prepared for hemoperfusion.

Hemofiltration↗
PubMed2002

[Study on the effect using hemoperfusion to treat tetramine poisoned patients].

OBJECTIVE: To evaluate the effect of hemoperfusion on tetramine poisoned patients. METHODS: Three tretramine poisoned cases treated with hemoperfusion were selected. The samples during and after hemoperfusion were collected and analyzed by gas chromatography. RESULTS: Tetramine concentration at the inlet of the artificial kidney kept the same level during hemoperfusion. After hemoperfusion, the tetramine concentration in patient plasma changed little in 72 hours. 1.03-1.55 mg of tetramine was adsorbed by the instrument of hemoperfusion after two hours' hemoperfusion. CONCLUSION: Although hemoperfusion was not so effective to reduce blood tetramine concentration in patients, it could clear about 1 mg tetramine for one time.

Bridged-Ring Compounds↗