Moon Jeongmi, Chun Byeongjo, Song Kyounghwan
Department of Emergency Medicine, Chonnam National University Medical School , Gwangju , South Korea.
Clin Toxicol (Phila). 2015 Feb;53(2):119-26. doi: 10.3109/15563650.2014.1001516. Epub 2015 Jan 22.
The effects of activated charcoal (AC) mixed with cathartics for gastric decontamination in the management of organophosphate (OP) poisoning remain unknown due to limited clinical evidence. This exploratory study assessed the effectiveness of premixed AC-sorbitol as a treatment for OP poisoning.
This retrospective observational case study included patients who either did not receive AC-sorbitol or received a single dose of AC-sorbitol within 24 h after OP ingestion. The patients were divided into three groups: no AC-sorbitol treatment, patients who received AC-sorbitol within 1 h of OP ingestion, and patients who received AC-sorbitol more than 1 h after OP ingestion. Mortality, the development of respiratory failure, and the duration of mechanical ventilation were used as outcome measurements for effectiveness, whereas aspiration pneumonia and electrolyte imbalance were employed as safety measurements.
Among 262 patients with OP poisoning, 198 were included. Of these, 133 patients did not receive AC-sorbitol, whereas 14 and 51 patients received AC-sorbitol within 1 h or more than 1 h after ingestion, respectively. The time from ingestion to hospital arrival and time from ingestion to administration of atropine and pralidoxime differed among the groups, whereas other characteristics, including age, amount ingested, and type of ingested OP, were similar among the groups. Univariate and multivariate analysis demonstrated that the administration of AC-sorbitol was not associated with outcome measures for effectiveness and did not significantly increase either aspiration pneumonia or electrolyte imbalances during hospitalization.
The administration of AC-sorbitol exerted neither beneficial nor harmful effects on the outcomes of OP-poisoned patients regardless of the time from OP ingestion to administration, compared with those of patients who did not receive AC-sorbitol. However, this study enrolled a small number of patients who received AC-sorbitol; further qualified trials with a sufficient number of patients are therefore needed.
由于临床证据有限，活性炭（AC）与泻药混合用于有机磷（OP）中毒洗胃的效果尚不清楚。本探索性研究评估了预混AC - 山梨醇治疗OP中毒的有效性。
这项回顾性观察性病例研究纳入了未接受AC - 山梨醇治疗或在OP摄入后24小时内接受单剂量AC - 山梨醇治疗的患者。患者分为三组：未接受AC - 山梨醇治疗组、OP摄入后1小时内接受AC - 山梨醇治疗组以及OP摄入后1小时以上接受AC - 山梨醇治疗组。死亡率、呼吸衰竭的发生情况以及机械通气时间用作有效性的结局指标，而吸入性肺炎和电解质失衡用作安全性指标。
在262例OP中毒患者中，198例被纳入研究。其中，133例患者未接受AC - 山梨醇治疗，而分别有14例和51例患者在摄入后1小时内或1小时以上接受了AC - 山梨醇治疗。各组从摄入到入院的时间以及从摄入到给予阿托品和解磷定的时间有所不同，而其他特征，包括年龄、摄入量和摄入的OP类型，在各组之间相似。单因素和多因素分析表明，AC - 山梨醇的使用与有效性结局指标无关，且在住院期间未显著增加吸入性肺炎或电解质失衡的发生率。
与未接受AC - 山梨醇治疗的患者相比，无论从OP摄入到给药的时间如何，AC - 山梨醇的使用对OP中毒患者的结局既无有益影响也无有害影响。然而，本研究纳入接受AC - 山梨醇治疗的患者数量较少；因此，需要进一步进行有足够患者数量的高质量试验。
