title: The role of therapeutic plasma exchange in poisonings and intoxications.
abstract: Poisonings, intoxications, and drug overdoses are common occurrences and rapid lowering of the toxin level is a cornerstone of all effective therapies. Therapeutic plasma exchange (TPE) has several unique characteristics that allow it to be a potentially effective therapy in rapidly achieving this goal. Specifically, TPE allows for the removal of large molecular weight, protein-bound molecules that have a small volume of distribution. Due to the nature of poisonings, intoxications, and drug overdoses, no randomized controlled trials studying the efficacy of TPE in these situations exist. Thus, careful interpretation and analysis of case reports and series are required to assess the potential efficacy of this therapy. Recent data suggest that TPE may also be effective in the therapy of patients receiving biologic treatments who develop life-threatening complications due to therapy.
authors.affiliation: Department of Medicine, University of Virginia Health System, Charlottesville, Virginia 22908-0466, USA.
authors.forename: Robert Clark
authors.initials: RC
authors.lastname: Schutt
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Rosner
mesh_terms: D001688:Biological Products / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D062787:Drug Overdose / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D009145:Mushroom Poisoning / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D010951:Plasma Exchange / Q000379:methods*; D011041:Poisoning / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D014688:Venoms / Q000009:adverse effects
chemical_list: D001688:Biological Products; D014688:Venoms; D002945:Cisplatin