Haemoperfusion

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Anna Lee

First posted June 2006

• Based on absorption by activated charcoal granules or ion exchange resins

• Blood passes via a HD extracorporeal circuit through a cartridge containing charcoal or resin, which removes large molecular weight, lipid-soluble, and protein-bound substances, thus is able to remove some renal and hepatic toxins.

• Does not remove urea and has no effect on acid-base balance or electrolytes

• Complications include

  • febrile reaction

  • thrombocytopenia, leucopenia and coalulopathy

  • hypoglycaemia and hypocalemia

  • hypotension

  • embolization of sorbent particles

• May be useful in some forms of severe poisoning caused by carbamazepine and theophylline

• Safety and efficacy remained unproven

• Recent studies showed high performance dialysis has comparable efficacy to haemoperfusion, and associated with lower procedural complication

• Future developments include removal of inflammatory cytokines in sepsis and uraemic toxins (β2 microglobulins) in renal failure

©Anna Lee, June 2006

©Charles Gomersall, August, 2008 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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