- James F Winchester, MD
James F Winchester, MD
- Professor of Medicine
- Icahn School of Medicine at Mount Sinai
Hemoperfusion consists of the passage of anticoagulated blood through a device, usually a column, that contains adsorbent particles . Introduced in the 1940s , the technique was refined during 1950 to 1970 and then introduced clinically for the treatment of poisoning in the 1970s and 1980s [3-5]. Despite its availability, this technique is only infrequently utilized .
The type of adsorbent particle utilized within a hemoperfusion device may vary. The most commonly available particles are activated charcoal and resin:
●Charcoal hemoperfusion has been used to treat a variety of conditions, including poisoning and hepatic failure .
●Certain resins (polystyrene, XAD series) are most effective for the removal of lipid-soluble drugs, with drug clearance rates from the blood frequently exceeding those achieved by charcoal hemoperfusion. Although available in Europe, they are no longer available in the United States since the market was limited.
●Fibers upon which immobilized polymyxin B are attached have also been placed in hemoperfusion cartridges for direct contact with blood for the removal of endotoxin and cytokines.
- Winchester JF, Boldur A, Oleru C, Kitiyakara C. Use of dialysis and hemoperfusion in treatment of poisoning. In: Handbook of Dialysis, 4th ed., Daugirdas JT, Blake PG, Ing TS (Eds), Lippincott Williams & Wilkins, Philadelphia 2007. p.300.
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