Hemoperfusion in "late" paracetamol poisoning

Seven patients who presented to hospital later than 10 h following an overdose of paracetamol were treated by charcoal hemoperfusion. In all cases there was a rapid fall in the plasma paracetamol concentrations, although the total amounts of drug removed varied from 364.5 to 6699 mg. One patient developed fulminant hepatic failure and died; the remainder recovered, sustaining only mild hepatic damage (maximum AST less than 1000 IU/L). Charcoal hemoperfusion may be effective in mitigating the severity of liver injury in those patients who are not eligible to receive specific antidotal therapy.