Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego · 2024
The modern view of the use of extracorporeal detoxification in the treatment of drug poisoning (overdose).
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Kurdil Natalia V, Andriushchenko Vladislava V, Ivashchenko Oleh V, Volosovets Anton O, Sheyman Borys S, Bobkovych Kateryna O, Palamar Borys I
Аннотация
OBJECTIVE: Aim: To analyze the results of the application of extracorporeal detoxification methods in the treatment of drug poisoning and their complications..
PATIENTS AND METHODS: Materials and Methods: The studied data of 129 patients aged 18-46 years with severe drug poisoning treated at the Kyiv toxicological center in 2010-2020. Statistical analysis was performed using the IBM SPSS Statistics 29.0.0.0 program; Kaplan-Meier method, log-rank test, p<0,05.
RESULTS: Results: Patients who started receiving renal replacement therapy 24-36 hours after hospitalization had the highest Kaplan-Meier survival rates. The Kaplan-Meier hazard ratio for death shows that the chances of survival progressively decrease from the 48th to the 72nd hour from the moment of admission of patients to hospital, and this trend is observed in patients with both anuria and oliguria. There was a statistically significant difference in Kaplan-Meier survival in patients receiving selective hemoperfusion on the background of renal replacement therapy (p=0,017); ozone therapy (p=0,051) and plasmapheresis (p=0,131) did not show statistical significance.
CONCLUSION: Conclusions: The combination of various methods of extracorporeal detoxification helps to increase the effectiveness of treatment of patients with drug poisoning due to the acceleration of the elimination of toxic substances and reduces the degree of manifestation of organotoxic effects.
PATIENTS AND METHODS: Materials and Methods: The studied data of 129 patients aged 18-46 years with severe drug poisoning treated at the Kyiv toxicological center in 2010-2020. Statistical analysis was performed using the IBM SPSS Statistics 29.0.0.0 program; Kaplan-Meier method, log-rank test, p<0,05.
RESULTS: Results: Patients who started receiving renal replacement therapy 24-36 hours after hospitalization had the highest Kaplan-Meier survival rates. The Kaplan-Meier hazard ratio for death shows that the chances of survival progressively decrease from the 48th to the 72nd hour from the moment of admission of patients to hospital, and this trend is observed in patients with both anuria and oliguria. There was a statistically significant difference in Kaplan-Meier survival in patients receiving selective hemoperfusion on the background of renal replacement therapy (p=0,017); ozone therapy (p=0,051) and plasmapheresis (p=0,131) did not show statistical significance.
CONCLUSION: Conclusions: The combination of various methods of extracorporeal detoxification helps to increase the effectiveness of treatment of patients with drug poisoning due to the acceleration of the elimination of toxic substances and reduces the degree of manifestation of organotoxic effects.