CHARCOAL HEMOPERFUSION FOR THEOPHYLLINE OVERDOSE - CASE-REPORT AND PROPOSAL FOR PREDICTING TREATMENT TIME

Charcoal hemoperfusion is effective in the treatment of theophylline o verdose. Estimation of the time required for charcoal hemoperfusion ha s been based on personal experience and judgment. We used pharmacokine tic data from a patient and from case reports to generate a formula fo r predicting treatment time. Pharmacokinetic parameters were calculate d using model-independent analysis of concentration-time curves from t wo treatments of charcoal hemoperfusion. These values were compared wi th published data and incorporated into a formula that was derived fro m the elimination rate constant to estimate treatment time of charcoal hemoperfusion: Time (min) = (ln conc(i) - ln conc(d))/0.0057, where t he concentration of theophylline is in mu mol/L. The formula may be va lid in patients in whom the serum theophylline concentration is less t han or equal to 516 mu mol/L or 92 mg/L. It may be used as a guide to estimate the length of charcoal hemoperfusion in the treatment of theo phylline toxicity. Its validation requires implementation and evaluati on in future cases.