Use of extracorporeal therapies to treat life-threatening intoxications

Pediatr Nephrol. 2024 Jan;39(1):105-113. doi: 10.1007/s00467-023-05937-7. Epub 2023 Mar 29.

Abstract

Toxic ingestions are a significant cause of pediatric morbidity and mortality, with some requiring extracorporeal removal for therapy. Given the emergent and life-threatening nature of such scenarios, it is paramount that clinicians caring for intoxicated children be familiar with the subject. This review summarizes the following: (a) the properties of a substance which lend it amenable to removal; (b) the current extracorporeal treatment modalities available for such removal (of which hemodialysis is typically the ideal choice); (c) an introduction and framework to use a quick reference guide from the Extrip organization, which has a website available to guide clinicians' rapid decisions; and (d) new membranes/approaches that may optimize clearance of certain intoxications.

Keywords: CRRT; Convection; Diffusion; ExTrip; MARS; Plasma exchange; SPAD; Volume of distribution.

Publication types

  • Review

MeSH terms

  • Child
  • Humans
  • Poisoning* / therapy
  • Renal Dialysis*