Ghannoum et al listed indications for extracorporeal therapy for a patient with theophylline poisoning. The authors are from multiple institutions in Canada, Europe and the United States and are members of the EXTRIP (Extracorporeal Treatments in Poisoning) workgroup.
Patient selection: theophylline poisoning
Molecular weight: 180.164 g
Method of extracorporeal therapy:
(1) intermittent hemodialysis
(2) continuous renal replacement therapy (CRRT)
(3) intermittent hemoperfusion
(4) exchange transfusion in a neonate
Indications for extracorporeal therapy:
(1) seizures
(2) life-threatening cardiac arrhythmias
(3) shock
(4) theophylline serum concentration
(4a) > 100 mg/L (> 555 µmol/L) in acute exposure
(4b) > 60 mg/L (> 333 µmol/L) in a chronic exposure AND (age >= 6 months AND <= 60)
(4c) > 50 mg/L (> 278 µmol/L) in a chronic exposure AND (age < 6 months OR age > 60 years)
(5) gastrointestinal decontamination with activated charcoal cannot be administered
(6) clinical deterioration despite optimal care
Additional comments:
(1) Multiple-dose activated charcoal should be continued during extracorporeal therapy.
Goal of therapy:
(1) clinical improvement
(2) serum theophylline concentration < 1.5 mg/dL (< 15 mg/L, < 83.257 µmol/L)
