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Rapid Elimination by Charcoal Hemoperfusion

Sally M. Ehlers, MD; Darwin E. Zaske, PharmD; Ronald J. Sawchuk, PhD

JAMA. 1978;240(5):474-475.

Abstract
Shock, seizures, cardiac arrhythmias, and respiratory and cardiac arrests developed in a patient who ingested 8.5 g of theophylline. Her condition improved and her serum theophylline concentration decreased from 170 to 20 mg/ml during six hours of charcoal hemoperfusion. Theophylline was removed from the serum by the uncoated charcoal column, as shown by an extraction efficiency approaching 100%. The maximum charcoal clearance of theophylline was 163 ml/kg/hr. The average endogenous theophylline clearance in adults is 50 ml/kg/hr and that achieved with hemodialysis is only 24.3 ml/kg/hr. Uncoated charcoal efficiently removes theophylline from the serum; charcoal hemoperfusion should be considered in severe theophylline toxic reactions.

(JAMA 240:474-475, 1978)

Author Affiliations
From the Departments of Medicine (Dr Ehlers) and Pharmacology (Dr Zaske), St Paul-Ramsey Hospital, St Paul, and the University of Minnesota Medical School, School of Medicine (Dr Ehlers) and College of Pharmacy (Drs Zaske and Sawchuk), Minneapolis.

Footnotes
Reprint requests to Department of Internal Medicine, St Paul-Ramsey Hospital, St Paul, MN 55101 (Dr Ehlers).

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