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Hemoperfusion : ウィキペディア英語版
Hemoperfusion

Hemoperfusion (British English: haemoperfusion) First introduced in the 1940s, the technique was refined during 1950 to 1970, and then introduced clinically for the treatment of poisoning in the 1970s and 1980s. It is sometimes used in drug overdose possibly in conjunction with other extracorporeal techniques such as hemodialysis(HD), peritoneal dialysis(PD), hemofiltration(HF), and hemodiafiltration(HDF).〔Manual of Clinical Dialysis, Second Edition, Ch. 16.2, pp. 229-232 Springer, Suhail Ahmad, University of Washington, Scribner Kidney Center, Northwest Kidney Centers, Seattle, Washington, USA〕
The US Food and Drug Administration(FDA) defines sorbent hemoperfusion as follows:
″(a) Identification. A sorbent hemoperfusion system is a prescription device that consists of an extracorporeal blood system similar to that identified in the hemodialysis system and accessories (876.5820) and a container filled with adsorbent material that removes a wide range of substances, both toxic and normal, from blood flowing through it. The adsorbent materials are usually activated-carbon or resins which may be coated or immobilized to prevent fine particles entering the patient's blood. The generic type of device may include lines and filters specifically designed to connect the device to the extracorporeal blood system. The device is used in the treatment of poisoning, drug overdose, hepatic coma, or metabolic disturbances.″
〔http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=876.5870 Code of Federal Regulations (CFR); Title 21, Volume 8; Revised as of April 1, 2014; CITE: 21CFR876.5870
See Related Information on Sorbent hemoperfusion system. in CDRH databases
TITLE 21--FOOD AND DRUGS
CHAPTER I--FOOD AND DRUG ADMINISTRATION
DEPARTMENT OF HEALTH AND HUMAN SERVICES
SUBCHAPTER H--MEDICAL DEVICES
PART 876 -- GASTROENTEROLOGY-UROLOGY DEVICES
Subpart F--Therapeutic Devices
Sec. 876.5870 Sorbent hemoperfusion system.

Two types of hemoperfusion are commonly used:
1) Charcoal hemoperfusion, which has been used to treat liver (hepatic) failure, various types of poisoning, and certain autoimmune diseases when coated with antigens or antibodies.
2) Certain resins(Polystyrene - XAD series) are frequently more efficient at clearing lipid-soluble drugs than charcoal hemoperfusion.
Hemoperfusion is also used in the treatment of specific intoxications, such as valproic acid, theophylline, and meprobamate.

〔Manual of Clinical Dialysis, Second Edition, Ch. 16.2.3, pp.229-232 Springer, Suhail Ahmad, University of Washington, Scribner Kidney Center, Northwest Kidney Centers, Seattle, Washington, USA〕〔http://cursoenarm.net/UPTODATE/contents/mobipreview.htm?10/53/11102〕
Despite its availability, this technique is only infrequently utilized as a medical process used to remove toxic substances from a patient's blood.〔http://www.uptodate.com/contents/hemoperfusion〕
== Complications ==
Complications of hemoperfusion may include thrombocytopenia, leucopenia, hypoglycemia, and some reduction in clotting factors, with recovery typically occurring in 1–2 days. Risk of bleeding is also higher because of high heparin dose and reduction in platelets and clotting factors.〔Manual of Clinical Dialysis, Second Edition, Ch. 16.2.3.2, pp.231-232 Springer, Suhail Ahmad, University of Washington, Scribner Kidney Center, Northwest Kidney Centers, Seattle, Washington, USA〕

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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