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Use of extracorporeal therapies to treat life-threatening intoxications

Kyle Deville1, Nathan Charlton2, David Askenazi3

  • 1Department of Pediatrics, Division of Pediatric Nephrology, University of Alabama at Birmingham, 1600 5Th Ave S, Park Place Suite 202, Birmingham, AL, 35233, USA.

Pediatric Nephrology (Berlin, Germany)
|March 29, 2023
PubMed

Insights

Extracorporeal removal, often via hemodialysis, can treat severe pediatric toxic ingestions. Clinicians should consult resources like the Extrip organization for rapid decision-making in these emergencies.

Area of Science:

  • Pediatric Toxicology
  • Nephrology
  • Critical Care Medicine

Background:

  • Toxic ingestions represent a major cause of severe illness and death in children.
  • Emergent situations necessitate prompt and informed clinical management, including extracorporeal therapies.

Approach:

  • This review outlines substance properties influencing extracorporeal removal efficacy.
  • It details current extracorporeal treatment modalities, highlighting hemodialysis as a primary option.
  • The Extrip organization's quick reference guide and decision-making framework are introduced.

Key Points:

  • Substance characteristics determine suitability for extracorporeal clearance.
  • Hemodialysis is frequently the optimal extracorporeal method for poison removal.
  • The Extrip website offers valuable tools for rapid clinical guidance.
  • Novel membranes and techniques show promise for enhanced intoxication clearance.

Conclusions:

  • Familiarity with extracorporeal removal principles is crucial for managing pediatric poisonings.
  • Utilizing available resources like the Extrip guide can improve patient outcomes.
  • Ongoing research into new membranes may further optimize treatment for toxic ingestions.

Keywords:
CRRTConvectionDiffusionExTripMARSPlasma exchangeSPADVolume of distribution

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