Open AccessContinuous Venovenous Hemofiltration as a Rescue Therapy for Severe Acetaminophen Toxicity in a Toddler
Author(s) -
Puspraj Awasthi,
Ankush Jindal,
Yogish Sharma,
Vijai Williams,
Namita Ravikumar,
Karthi Nallasamy,
Suresh Kumar Angurana
Publication year - 2020
Publication title -
journal of pediatric intensive care
Language(s) - English
Resource type - Journals
eISSN - 2146-4618
pISSN - 2146-4626
DOI - 10.1055/s-0040-1712158
Subject(s) - medicine , acetaminophen , rescue therapy , antidote , acetylcysteine , hemofiltration , fulminant , toddler , accidental , intensive care medicine , anesthesia , toxicity , surgery , hemodialysis , psychology , developmental psychology , biochemistry , chemistry , physics , acoustics , antioxidant
Acetaminophen poisoning is one of the common accidental poisoning in children. Accidental administration of mismatched doses of drops for syrups can lead to life-threatening overdose. N-acetylcysteine (NAC) is the specific antidote; however, extracorporeal therapy such as continuous venovenous hemofiltration (CVVH) can be used as a rescue measure when there is no improvement despite adequate NAC therapy and can be lifesaving. We reported an 18-month-old male infant patient who presented with acetaminophen poisoning following accidental ingestion of acetaminophen drops in place of syrup and developed fulminant hepatic failure. Treatment with NAC did not lead to improvement and CVVH was used as a rescue therapy for 24 hours which led to dramatic clinical and biochemical improvement with intact neurological outcome.