Because of the apparent beneficial effects in patients with hepatic failure and drug intoxication, it had been felt by representatives of the 'Reye syndrome team' and the hemodialysis unit that charcoal hemoperfusion might aid patients with Reye syndrome. Although removal of various clotting factors is a potential risk of hemoperfusion, severe coagulopathy is not a frequent complication with modern charcoal filters. In 1977 a prospective randomized study of the effectiveness of charcoal hemoperfusion in patients with Reye syndrome was started, based on the reported benefit of hemoperfusion in patients with fulminant hepatic failure. The protocol was terminated after the first three patients undergoing perfusion developed severe coagulation disturbances. These three patients form the basis of this report. The intention in reporting this experience is to alert others to the problems of charcoal hemoperfusion. It appears that severe coagulopathy may follow this procedure in children, especially when there is an underlying coagulation abnormality or severe liver disease that prevents resynthesis of coagulation factors.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health