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James F. Winchester, MB, MRCP; Michael C. Gelfand, MD; Michael Helliwell, MB, MRCP; John Allister Vale, MB, MRCP; Roy Goulding, BSc, MD, FRCP, FRCPath; George E. Schreiner, MD

Arch Intern Med. 1981;141(3):370-374.

Abstract
• Hemodialysis or sorbent hemoperfusion has been used in the management of clinical overdose of salicylates or acetaminophen. Hemodialysis offers considerable benefit in severe salicylate poisoning and is preferred to hemoperfusion or peritoneal dialysis, since it more rapidly corrects acid-base and electrolyte abnormalities than does hemoperfusion, and since it is clearly more efficient than is peritoneal dialysis for the removal of salicylates. Charcoal hemoperfusion in animal studies and hemodialysis in man have been shown to accelerate acetaminophen elimination from the body. Hemodialysis and hemoperfusion are of questionable benefit in clinical acetaminophen overdose. However, our clinical experience to date with charcoal hemoperfusion in "late" acetaminophen overdose has been associated with a less notable increase in liver enzyme concentrations in comparison with results of retrospective studies of series of patients treated or not treated with sulfhydryl donors.

(Arch Intern Med 1981;141:370-374)

Author Affiliations
From the Department of Medicine, Division of Nephrology, Georgetown University Hospital, Washington, DC (Drs Winchester, Gelfand, and Schreiner), and the Poisons Unit, Guy's Hospital, London (Drs Goulding, Helliwell, and Vale).

Footnotes
Reprint requests to the Department of Medicine, Division of Nephrology, 503 Kober Cogan Bldg, Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007 (Dr Winchester).

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