2022 Volume 13 Issue 1 Pages 69-72
Direct hemoperfusion (DHP) with activated carbon adsorption membranes are used for patients presenting with methotrexate (MTX) intoxication due to its high dose administration and delayed excretion. There have been few reports on the efficacy and clearance of blood purification device when it is used for a prolonged time. We report a case of a 3-year-old with acute lymphoblastic leukemia who developed MTX intoxication after high dose administration and recovered without complications after treatment with prolonged DHP therapy for up to 24 hours. During the DHP therapy, the blood concentration of MTX and its clearance were closely monitored. DHP was performed at a blood flow rate (Qb) of 60 mL/min. After 16 hours, the removal efficiency and clearance were maintained at 0.85 and 48.9 mL/min, respectively, showing a good removal rate. There is a possibility that DHP can be performed longer than the designated time in pediatric patients, with less Qb than adults to reach a sufficient blood purification.
