RT Journal
A1 Risler T, Grabensee B
T1 HEmoperfusion in the management of digoxin toxic reaction
JF JAMA
JO JAMA
YR 1979
FD September 14
VO 242
IS 11
SP 1140
OP 1140
DO 10.1001/jama.1979.03300110014014
UL http://dx.doi.org/10.1001/jama.1979.03300110014014
AB To the Editor.— 
    Smiley and associates (240:2736,1978) recommend hemoperfusion as a standard treatment of digoxin intoxication. According to our own investigations1 and those of others,2,3 we agree with these results as far as high clearance rates for digoxin are concerned. But in our opinion, plasma clearance is only one factor attributing to the efficiency of hemoperfusion. At least as important is the plasma-tissue distribution of the drug that is to be eliminated. Less than 1% of the total body pool of digoxin (normal range, 1 to 2 mg) is accumulated in the plasma (normal concentration, 1 to 2 ng—L).In our experimental model, we used dogs because their digoxin pharmacokinetics are comparable with those in humans.4,5 In 12 dogs (body weight, 20 to 25 kg) chronically digitalized with 0.05 mg/kg of digoxin intravenously for three days before the hemoperfusion experiment, we tested the influence of the absorbent