Park Sohyun, Lee Hui Jai, Shin Jonghwan, You Kyoung Min, Lee Se Jong, Jung Euigi
Department of Emergency Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul 07061, Republic of Korea.
Department of Emergency Medicine, Sejong General Hospital, Bucheon, Gyeonggi-do 14754, Republic of Korea.
Emerg Med Int. 2018 Oct 3;2018:4642127. doi: 10.1155/2018/4642127. eCollection 2018.
Activated charcoal is the most frequently and widely used oral decontaminating agent in emergency departments (EDs). However, there is some debate about its clinical benefits and risks. In Korea, activated charcoal with sorbitol was unavailable as of the mid-2015, and our hospital had been unable to use it from September 2015. This study examined the differences of clinical features and outcomes of patients during the periods charcoal was and was not available.
We retrospectively reviewed the electronic medical records of patients who had visited an urban tertiary academic ED for oral drug poisoning between January 2013 and January 2017.
For the charcoal-available period, 413 patients were identified and for the charcoal-unavailable period, 221. Activated charcoal was used in the treatment of 141 patients (34%) during the available period. The mortality rates during the available and unavailable periods were 1.9 and 0.9%, respectively ( = 0.507). There was also no interperiod difference in the development of aspiration pneumonia (9.9 versus 9.5%, = 0.864), the endotracheal intubation rate (8.4 versus 7.2%, = 0.586), and vasopressor use (5.3 versus 5.0%, = 0.85). Intensive care unit (ICU) admission was higher in the unavailable period (5.8 versus 13.6%, = 0.001). ICU days were lower in the unavailable period (10 [4.5-19] versus 4 [3-9], = 0.01). Hospital admission (43.3 versus 29.9%, = 0.001) was lower in the unavailable period.
In this single center study, there appeared to be no difference in mortality, intubation rates, or vasopressor use between the charcoal-available and charcoal-unavailable periods.
活性炭是急诊科最常用且应用广泛的口服去污剂。然而，关于其临床益处和风险存在一些争议。在韩国，截至2015年年中，含山梨醇的活性炭无法获取，自2015年9月起我院也无法使用。本研究探讨了活性炭可获取期和不可获取期患者的临床特征及结局差异。
我们回顾性分析了2013年1月至2017年1月期间因口服药物中毒就诊于一家城市三级学术急诊科患者的电子病历。
在活性炭可获取期，共识别出413例患者；在不可获取期，有221例。在可获取期，141例患者（34%）接受了活性炭治疗。可获取期和不可获取期的死亡率分别为1.9%和0.9%（P = 0.507）。吸入性肺炎发生率（9.9%对9.5%，P = 0.864）、气管插管率（8.4%对7.2%，P = 0.586）以及血管活性药物使用率（5.3%对5.0%，P = 0.85）在不同时期也无差异。不可获取期重症监护病房（ICU）入住率更高（分别为5.8%和13.6%，P = 0.001）。不可获取期的ICU住院天数更少（分别为10天[4.5 - 19天]和4天[3 - 9天]，P = 0.01）。不可获取期的住院率更低（分别为43.3%和29.9%，P = 0.001）。
在这项单中心研究中，活性炭可获取期和不可获取期在死亡率、插管率或血管活性药物使用方面似乎没有差异。
