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J Pediatr Intensive Care 2021; 10(02): 159-161
DOI: 10.1055/s-0040-1712158
Case Report

Continuous Venovenous Hemofiltration as a Rescue Therapy for Severe Acetaminophen Toxicity in a Toddler

Puspraj Awasthi
1   Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Ankush Jindal
1   Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Yogish Sharma
1   Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Vijai Williams
1   Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Namita Ravikumar
1   Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Karthi Nallasamy
1   Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
,
Suresh Kumar Angurana
1   Division of Pediatric Critical Care, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
› Author Affiliations Funding None.
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Abstract

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.

Keywords

continuousvenovenous hemofiltration - acetaminophen - poisoning


Publication History

Received: 20 January 2020

Accepted: 17 April 2020

Article published online:
22 May 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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