title: Massive digitoxin intoxication. Treatment of Amberlite XAD 4 resin hemoperfusion.
abstract: Amberlite XAD 4 resin hemoperfusion was studied in the treatment of massive digitoxin overdosage. In vitro experiments using 4 hour resin hemoperfusion showed that digitoxin is removed 100 percent from an isotonic saline reservoir, 83 +/- 14 percent from plasma, and 42 +/- 7 percent from whole blood. In dogs, serum level reduction is fast: 50 +/- 12 percent in 15 minutes, 71 +/- 6 percent in 180 minutes; mean plasma clearance is 24 +/- 6.5 ml/min for a 150 ml/min plasma flow rate. Eleven patients with massive digitoxin overdosage recovered with resin hemoperfusion. Serum level reduction was 32 +/- 14 percent with a 325 g resin column, 59 +/- 6 percent with two 325 g resin columns in series as compared with a 4.5 +/- 1.7 percent reduction without perfusion. Hemoperfusion increased the rate of spontaneous removal of digitoxin 8.6 +/- 3.3 times with a 325 g resin column, and 14 +/- 7.4 times with two 325 g resin columns.
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D004074:Digitoxin / Q000097:blood / Q000378:metabolism / Q000506:poisoning*; D004285:Dogs; D006207:Half-Life; D006464:Hemoperfusion; D006801:Humans; D007700:Kinetics; D008875:Middle Aged; D011137:Polystyrenes / Q000627:therapeutic use*
chemical_list: D011137:Polystyrenes; C003771:Amberlite XAD-2 resin; D004074:Digitoxin