Dario Jimenez Acosta, Aguilar Ana, Jimenez Fernando, Duenas Anunciata, Castillo Maria, Morales Miguel, Sadva Diego, Paredes Gustavo, Pazos Ernesto, Trujillo Freddy and Rhon Jaime
Universidad Central del Ecuador, Ecuador
: J Kidney
Introduction: Acute intoxication is an important cause of admission to intensive care unit in Ecuador; 8% of patients who needed renal replacement therapy developed by DIALNEF group since 2014 were by acute poisoning. The haemoperfusion with macro adsorbent resin offers advantages to clear toxins with medium molecular weight, high bound proteins and lipophilic characteristics. Objective: To evaluate the role of early haemoperfusion as a therapy in severe acute intoxication. Mortality was primary outcome. Methodology: A case and controls study was delivery in poisoning patients with neurologic deterioration by drugs with high bound proteins. Group 1 (n: 25 patients) were in haemoperfusion by 3 hours with MG-150- 250 macro adsorbent resin cartridge after general treatment for detoxifications versus group 2 (n: 25 patients) patients without access to haemoperfusion treatment. APACHE and SOFA scores were used to severity evaluation. Results: Severity score APACHE II was G1:19 and G2: 15 (p:0.03) and SOFA G1:8.9 and G2:6 (p:0.02). UCI stay was G1:3.5 and G2: 5.4 days (p:0.11). Mortality in G1: 0 and G2: 5 (p=0,018). Conclusions: The present study shows benefits of haemoperfusion in patients with severe acute intoxications. In addition, it shows how dramatically decreases the mortality in patients with high APACHE 2 score. Also, it was effective because decrease the permanence either in intensive care unit and hospitalization, therefore the cost is reduced. Haemoperfusion is a suitable technic for effective treatment in poisoning patients and clearance of high bound protein drugs.
Dario Jiménez Acosta has completed his Medical graduate from Universidad Central del Ecuador and Post-doctoral studies from Eugenio Espejo hospital and Nephrology mini fellowship at University of Colorado at Denver. He is Head of Nephrology Department at Enrique Garcés Hospital, Medical Director of Dialnef Critical Care Nephrology and Medicine Professor at Universidad Central del Ecuador.
