Hemoperfusion Study with Carbamazepine in Vitro

Sorption efficacy of active charcoal, Amberlite XAD-2 and Amberlite XAD-4 in hemoperfusion with carbamazepine was investigated in vitro. Authors carried out 15 hemoperfusions with carbamazepine in a closed system using the above mentioned sorbents; The perfusion solution used was 3,000 ml of 0.9% NaCl. The carbamazepine concentration in the solution was 52.5±3.0 mg/L. In addition, two in vitro hemoperfusions with carbamazepine using Amberlite XAD-2 sorbent and 1.500 ml of human plasma as a perfusion solution, were also performed. The concentration of carbamazepine in plasma was 50.4±1.2 mg/L. Individual hemoperfusions lasted 5 hours. Zero values of carbamazepine were achieved after 120 min of Amberlite XAD-2 or Amberlite XAD-4 hemoperfusion in 0.9% NaCl and after 240 min of hemoperfusion in human plasma. The results gathered suggest that the most effective in vitro hemoperfusion with carbamazepine was obtained with Amberlite XAD-2 or Amberlite XAD-4 and the least effective was with active charcoal. The authors recommend the use of hemoperfusion with Amberlite XAD-2 or Amberlite XAD-4 for acute intoxications with carbamazepine in humans. In addition, authors successfully performed 5-hour hemoperfusion using Amberlite XAD-4 in vivo, in an 18-year-old girl, who suffered from acute carbamazepine intoxication after a suicidal attempt. This treatment led to the rapid survival.