Hemodialysis for Acetaminophen Detoxification

Massive acetaminophen ingestion with early metabolic acidosis and coma: treatment with IV NAC and continuous venovenous hemodiafiltration

“…9,10 Several reports demonstrate that acetaminophen can be removed by hemodialysis. [11][12][13][14] However, there are few case reports describing the use of hemodialysis for acute acetaminophen overdose. Pond described a patient who presented late after an estimated 58 g acetaminophen ingestion.…”

Blood Purification for Intoxications and Drug Overdose

“…Low MW toxins such as ethylene glycol (EG), with a MW of 62 Da, There are two main pathways for acetaminophen metabolism: conjugation with sulfate and glucuronide (accounting for 90% of the ingested dose) and metabolism by the cytochrome P-450 oxidase enzyme system (accounting for 5% of ingested dose). 27 In humans, HD and CH have been shown to reduce plasma half-life compared with conventional therapies. 25 N-acetyl-p-benzoquinone imine (NAPQI) has a direct toxic effect on the liver and on erythrocytes.…”