Fixed-Bed Charcoal Hemoperfusion in the Treatment of Drug Overdose and Chronic Renal Failure

Abstract

The fixed bed charcoal hemoperfusion system has now been applied extensively in animals and humans for evaluation of safety and efficacy in a variety of disorders.^1,2 It is clearly appropriate that all of the methods which have been applied to treating intoxication by hemoperfusion be considered together although it is doubtful that an agreement will be reached on the superiority of one technique over any other at this time. The classic loose-bed arrangement of clean charcoal packed loosely in a column with blood perculating through its matrix was initially evaluated by Yatzidis and it was found to have some intolerable side effects, particularly on formed blood elements.³ Furthermore, charcoal particulate emboli was a definite threat to the safty of such a device. Chang in his pioneering studies of the artifical cell attempted to overcome both problems of emboli as well as the platelet depression by placing a thin coat over the charcoal.4 A still unsettled issue using Chang’s approach is the probability that the coat will decrease charcoal’s absorability and therefore its efficiency, partially offseting the advantage of charcoal as a therapeutic agent to remove noxious substances.