Indication of hemodialysis includes -
Indications for haemodialysis-- Haemodialysis may be considered in those patients not responding to standard therapeutic measures while treating a dialysable toxicant (vide infra). It may also be considered a pa of suppoive care whether the toxicant is dialysable or not in the following situations: Stage 3 or 4 coma, or hyperactivity caused by a dialysable agent which cannot be treated by conservative means, marked hyperosmolality which is not due to easily corrected fluid problems, severe acid-base disturbance not responding to therapy, or severe electrolyte disturbance not responding to therapy. - Best indications: Dialysis should be initiated, regardless of clinical condition, in the following situations: after heavy metal chelation in patients with renal failure, and following significant ethylene glycol or methanol ingestion. - Very good indications: Dialysis is usually effective in patients with severe intoxications with the following agents: - Lithium - Phenobarbitone - Salicylates - Theophylline. - Fairly good indications: Dialysis may be initiated following exposure to the following agents, if clinical condition deems the procedure necessary (patient deteriorating despite intense suppoive care): - Alcohols - Amphetamines - Anilines - Antibiotics - Boric acid - Barbiturates (sho acting) - Bromides - Chlorates - Chloral hydrate - Iodides - Isoniazid - Meprobamate - Paraldehyde - Fluorides - Quinidine - Quinine - Strychnine - Thiocyanates. - Poor indications: Dialysis can be considered as a suppoive measure in the presence of renal failure, following exposure to: - Paracetamol - Antidepressants - Antihistamines - Belladonna alkaloids - Benzodiazepines - Digitalis and related glycosides - Glutethimide - Opiates - Methaqualone - Phenothiazines - Synthetic anticholinergics. REF:THE SYNOPSIS OF FORENSIC MEDICINE AND TOXICOLOGY:K S NARAYANA REDDY;PAGE NO 289
Benzodiazepines poisoning
Methanol poisoning
Hyperkalemia
Barbiturate poisoning
Poisoning