| Title |
Treatment of a patient with severe digitoxin intoxication by Fab fragments of anti-digitalis antibodies
|
|---|---|
| Published in |
Intensive Care Medicine, July 1992
|
| DOI | 10.1007/bf01694351 |
| Pubmed ID | |
| Authors |
V. Kurowski, H. Iven, H. Djonlagic |
| Abstract |
A massive digitoxin (DGTX) intoxication in a 36-year-old man (35 mg DGTX) was treated by prolonged and repeated i.v.-infusions of Fab fragments of anti-digitalis antibodies (FAB). Blood and urine samples were collected over a 98 h period for monitoring the efficacy and adequacy of FAB treatment. DGTX concentrations were determined after protein precipitation (release of FAB-bound and protein-bound DGTX) in unprocessed serum and urine samples, and after aliquots of these samples had been dialysed in vitro against DGTX-free buffer (elimination of DGTX not bound to FAB). The difference in DGTX concentration between the unprocessed and dialysed samples was the amount of DGTX bound to plasma proteins and the small fraction of unbound DGTX being relevant for the therapeutic and toxic effects of the drug. Before FAB therapy was started, the total serum DGTX concentration was 535 nmol/l. The first FAB infusion (320 mg) was started 11 h after drug ingestion. Since this amount of FAB was insufficient to bind all DGTX present in the serum, cardiac DGTX toxicity (total AV-block) persisted. During a second FAB infusion (400 mg) the patient reverted to regular AV-conduction. At this time most of the DGTX in serum was FAB-bound. Toxic symptoms (sinus arrest) reappeared twice and were accompanied by increasing amounts of non-antibody-bound DGTX in the serum. Additional application of FAB (2 x 80 mg) resulted in the immediate disappearance of arrhythmia. During FAB-treatment total DGTX serum concentrations and renal DGTX clearance rose, indicating redistribution of drug from tissue to serum and urinary elimination of FAB-bound DGTX, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) |
Mendeley readers
The data shown below were compiled from readership statistics for 13 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 13 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Professor > Associate Professor | 2 | 15% |
| Student > Bachelor | 2 | 15% |
| Other | 1 | 8% |
| Lecturer | 1 | 8% |
| Researcher | 1 | 8% |
| Other | 1 | 8% |
| Unknown | 5 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 3 | 23% |
| Immunology and Microbiology | 2 | 15% |
| Psychology | 2 | 15% |
| Social Sciences | 1 | 8% |
| Biochemistry, Genetics and Molecular Biology | 1 | 8% |
| Other | 0 | 0% |
| Unknown | 4 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 March 2019.
All research outputs
#7,451,942
of 22,782,096 outputs
Outputs from Intensive Care Medicine
#2,837
of 4,973 outputs
Outputs of similar age
#5,481
of 18,783 outputs
Outputs of similar age from Intensive Care Medicine
#4
of 10 outputs
Altmetric has tracked 22,782,096 research outputs across all sources so far. This one is in the 44th percentile – i.e., 44% of other outputs scored the same or lower than it.
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We're also able to compare this research output to 10 others from the same source and published within six weeks on either side of this one. This one has scored higher than 6 of them.