title: Enhanced poison elimination in critical care.
abstract: Nephrologists and critical care physicians are commonly involved in the treatment of severely poisoned patients. Various techniques exist presently to enhance the elimination of poisons. Corporeal treatments occur inside of the body and include multiple-dose activated charcoal, resin binding, forced diuresis, and urinary pH alteration. Extracorporeal treatments include hemodialysis, hemoperfusion, peritoneal dialysis, continuous renal replacement therapy, exchange transfusion, and plasmapheresis. This review illustrates the potential indications and limitations in the application of these modalities as well as the pharmacological characteristics of poisons amenable to enhanced elimination.
authors.affiliation: University of Montreal, Verdun Hospital, Montreal, Qc, Canada H4G2A3. marcghannoum@gmail.com
authors.forename: Marc
authors.initials: M
authors.lastname: Ghannoum
authors.forename: Sophie
authors.initials: S
authors.lastname: Gosselin
mesh_terms: D000931:Antidotes / Q000627:therapeutic use; D002606:Charcoal / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D004232:Diuretics / Q000627:therapeutic use; D005078:Exchange Transfusion, Whole Blood; D005440:Fluid Therapy; D006464:Hemoperfusion; D006801:Humans; D007475:Ion Exchange Resins / Q000627:therapeutic use; D010956:Plasmapheresis; D011041:Poisoning / Q000628:therapy*; D017582:Renal Replacement Therapy / Q000379:methods
chemical_list: D000931:Antidotes; D004232:Diuretics; D007475:Ion Exchange Resins; D002606:Charcoal