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June 11, 1982

Extracorporeal detoxification: still debatable

JAMA. 1982;247(22):3047-3048. doi:10.1001/jama.1982.03320470011006

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Hemoperfusion and hemodialysis enthusiasts are criticized because there still are no randomized comparisons. This is a difficult thing to accomplish for drug overdose cases," asserted John Maher, MD, director of nephrology at the Uniformed Services University of the Health Sciences, Bethesda, Md, during a panel discussion at the recent Chicago meeting of the American Society for Artificial Internal Organs (ASAIO).

"But I would stress that the problem will not go away," Maher said.

According to the National Center for Health Statistics, for 1978, the latest year for which figures are available, an estimated 11,430 drug-related deaths occurred in the United States.

Both hemodialysis and hemoperfusion are considered the state of the art in invasive detoxification schemes. Hemodialysis incorporates permeable membranes in removing low-molecular-weight toxins from the blood, whereas hemoperfusion employs absorption columns to extract lipid- or protein-bound substances from plasma.

Of all the patients admitted yearly for overdose in the