PMID: 11927906Apr 3, 2002Paper

Treatment of acetaminophen-induced hepatitis and fulminant hepatic failure with extracorporeal sorbent-based devices

Advances in Renal Replacement Therapy
Stephen R AshVinod K Rustgi

Abstract

When a patient with acetaminophen overdose arrives in the emergency room more than 14 hours after ingestion, the value of N-acetylcysteine is unproven and patient mortality is at least 10%. Anecdotal case reports have indicated benefit of extracorporeal detoxification of these late-arriving patients with acetaminophen overdose. We identified 10 patients with serious acetaminophen overdose, 8 that arrived in the emergency room 16 to 44 hours after acetaminophen overdose with plasma levels predicting severe hepatic toxicity, and 2 that arrived in the emergency room 8 to 12 hours after overdose but with exceedingly high levels. All patients developed severe hepatitis (mean peak alanine aminotransferase, 4,052; mean peak protime, 25 seconds). At 16 to 68 hours after overdose, the patients were treated for 4 to 6 hours with the Liver Dialysis System (Hemocleanse Inc, W. Lafayette, IN), a single-access hemodiabsorption system indicated for treatment of serious drug overdose and for treatment of hepatic encephalopathy. Acetaminophen levels fell an average of 73% during treatment. Treatment was repeated 24 or 48 hours later if acetaminophen was still measurable in plasma. All 10 patients recovered intrinsic liver function and general h...Continue Reading

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Citations

Aug 19, 2014·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·S GosselinUNKNOWN Extrip Workgroup
Sep 3, 2003·Liver International : Official Journal of the International Association for the Study of the Liver·H K TanK T Woo
Jan 27, 2009·The Mount Sinai Journal of Medicine, New York·Hui-Hui TanPaul Martin
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Oct 22, 2004·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Christina ChanMartin L Yarmush
Feb 11, 2005·Current Opinion in Gastroenterology·David Novak, James H Lewis
Mar 25, 2004·World Journal of Gastroenterology : WJG·Ying-Jie WangHong-Wei Wen

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