Clinical Investigation Treatment of 150 Cases of Life-Threatening Digitalis Intoxication With Digoxin-Specific Fab Antibody Fragments
نویسنده
چکیده
One hundred fifty patients with potentially life-threatening digitalis toxicity were treated with digoxin-specific antibody fragments (Fab) purified from immunoglobulin G produced in sheep. The dose of Fab fragments was equal to the amount of digoxin or digitoxin in the patient's body as estimated from medical histories or determinations of serum digoxin or digitoxin concentrations. The youngest patient received Fab fragments within several hours of birth, and the oldest patient was 94 years old. Seventy-five patients (50%) were receiving long-term digitalis therapy, 15 (10%) had taken a large overdose of digitalis accidentally, and 59 (39%) had ingested an overdose of digitalis with suicidal intent. The clinical response to Fab was unspecified in two cases, leaving 148 patients who could be evaluated. One hundred nineteen patients (80%) had resolution of all signs and symptoms of digitalis toxicity, 14 (10%) improved, and 15 (10%) showed no response. After termination of the Fab infusion, the median time to initial response was 19 minutes, and 75% of the patients had some evidence of a response by 60 minutes. There were only 14 patients with adverse events considered to possibly
منابع مشابه
[Suicidal digitalis poisoning: considerations concerning treatment strategy with antibodies].
Suicidal digitalis poisoning is life-threatening and often has a fatal outcome. The treatment and clinical course of acute poisoning with 250 mg digitoxin in a depressive male patient aged 48 years are reported. Marked elevation of serum digitoxin level (360 nmol/l 8 hours after ingestion) and initial hyperkalemia (5.7 mmol/l) as well as the history of excessive dose intake, pointed toward seve...
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