Hemostatic Changes Induced In Vitro by Hemoperfusion Over Activated Charcoal

Abstract

The effect of hemoperfusion over charcoal on changes in platelet counts, coagulation factor concentrations and standard coagulation tests were determined during a two-hour in vitro perfusion of normal blood through a column containing 20 gm of activated charcoal, either uncoated or coated with 0.5% acrylonitrile/dimethylaminoethyl methacrylate copolymer (AN/DMAEMA). With citrated whole blood, platelet counts fell by 15% during hemoperfusion over coated or uncoated charcoal and also during passage through an identical empty chamber. On the other hand, with heparinized whole blood, platelet counts fell by 90% during hemoperfusion over uncoated charcoal, and 25% during hemoperfusion over coated charcoal. The concentrations of coagulation factors ILV, IX, X and XI1 were reduced during hemoperfusion over uncoated charcoal, while those of factors I1 and X were reduced and that of factor VII increased during hemoperfusion over coated charcoal. Perfusion with heparinized, platelet-rich plasma resulted in small reductions in platelet counts, suggesting that either erythrocyte disruption or the physical effects of intact red cells play a major role in producing the hemostatic abnormalities occurring during whole blood hemoperfusion. The method described may be used to assess the hemocompatibility of polymer coatings for charcoal particles, to investigate the nature of the interaction between platelets and arti-

Treatment of ibuprofen toxicity with serial charcoal hemoperfusion and hemodialysis in a dog

“…The thrombocytopenia was likely due to loss of platelets as they adhered to the activated charcoal adsorbent during hemoperfusion, destruction of platelets by the surface irregularities of the charcoal cartridge, and from blood loss both from the suspected gastric ulceration and from the dialysis catheter site. Studies in people report thrombocytopenia as a common complication of hemoperfusion therapy with a decrease of up to 20–50% in the patient's platelet count following therapy . The prolonged clotting times were likely due to the binding of the clotting factors in the charcoal cartridge.…”

“…The prolonged clotting times were likely due to the binding of the clotting factors in the charcoal cartridge. It is reported in the human literature that the use of charcoal cartridges leads to a decrease in coagulation factors (mainly II, V, IX, and X) by up to 10–25% …”

“…Studies in people report thrombocytopenia as a common complication of hemoperfusion therapy with a decrease of up to 20-50% in the patient's platelet count following therapy. [11][12][13] The prolonged clot-ting times were likely due to the binding of the clotting factors in the charcoal cartridge. It is reported in the human literature that the use of charcoal cartridges leads to a decrease in coagulation factors (mainly II, V, IX, and X) by up to 10-25%.…”

“…It is reported in the human literature that the use of charcoal cartridges leads to a decrease in coagulation factors (mainly II, V, IX, and X) by up to 10-25%. [11][12][13] The use of mannitol for renoprotection remains controversial as its free radical scavenging effects have been mostly demonstrated in experimental models of kidney injury. The role of mannitol in preventing or treating acute kidney injury is not clearly defined.…”