Developments in extracorporeal therapy for the poisoned patient |
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| Institution: | 1. Department of Neurosurgery and Neurooncology, Medical University of Lodz, Barlicki University Hospital, Lodz, Poland;2. Department of Molecular Pathology and Neuropathology, Medical University of Lodz, Lodz, Poland;3. Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland;4. Department of Pathology, Medical University of Lodz, Lodz, Poland;5. Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland;1. School of Environment and Australian Rivers Institute, Griffith University, Southport, Qld 4222, Australia;2. WasserCluster Lunz – Biologische Station GmbH, Dr. Carl Kupelwieser Promenade 5, A-3293 Lunz am See, Austria;3. Sichuan Zhonghuanlixin Environmental Protection Consulting Co., Ltd., Bazhong, Sichuan Province 636000, PR China;4. Fisheries College, Jimei University, Xiamen, Fujian, PR China;5. State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, 8 Dayangfang, Beiyuan, Anwai, Beijing 100012, PR China;1. Servicio de Nefrología, Hospital Universitario Príncipe de Asturias, Madrid, España;2. Unidad de Cuidados intensivos, Hospital Universitario Príncipe de Asturias, Madrid, España |
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| Abstract: | The modern use of extracorporeal therapies to treat poisoning and drug overdoses dates back to the early 20th century and has evolved along with their use as treatment for acute kidney injury or as maintenance therapy in advanced kidney disease. As our understanding of drug pharmacokinetics and membrane materials has increased, the technologies of extracorporeal therapy and their applications have become more sophisticated. Despite that, there is little robust evidence to guide clinicians on the optimal use of extracorporeal therapy in treating poisoning beyond case reports and series. New efforts are underway to remedy that: the Extracorporeal Treatments in Poisoning Workgroup (EXTRIP) is an international effort on the part of nephrologists, pharmacists and toxicologists to review the available data and formulate evidence-based guidelines on how to use extracorporeal techniques to treat poisoning and improve patient outcomes. Meanwhile, new techniques and membranes are under development. This review will summarize those key scientific and technologic developments, the efforts to optimize their use and new directions in research. |
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