Department of Medicine, University of Ottawa, 162 Parkdale Avenue, Ottawa, Ontario, K1Y 1J8, Canada.
The Ottawa Hospital - Riverside Campus, 1967 Riverside Drive, Ottawa, Ontario, K1H 7W9, Canada.
Syst Rev. 2018 Dec 28;7(1):250. doi: 10.1186/s13643-018-0926-z.
Toxic alcohols have been implicated in accidental ingestions and intentional exposures. Recognition of toxic alcohol poisoning is challenging. The main treatment modalities include antidotes with alcohol dehydrogenase inhibitors and dialysis. Current guidelines exist for both methanol and ethylene glycol intoxication. However, treatment consensus related to other toxic alcohols is limited. Furthermore, uncertainties regarding thresholds for when to initiate antidotes and dialysis persist. As a consequence, variations exist in the interventions utilized for management of all toxic alcohol poisonings. To our knowledge, no prior systematic review of clinical outcomes of toxic alcohols exists. The objective of this study is to summarize existing evidence on short- and long-term outcomes of patients following toxic alcohol poisonings, including methanol, ethylene glycol, isopropanol, propylene glycol, and diethylene glycol.
A literature search in PubMed, MEDLINE, and EMBASE will be performed based on pre-determined criteria. There will be no restrictions on publication dates or languages. The search will be supplemented by manual scan of bibliographies of eligible studies and gray literature assessment. Observational studies and clinical trials will be included in this review. Once eligible studies have been selected based on pre-specified criteria, two investigators will extract relevant data independently and perform quality assessment per validated tools. A pooled analysis of mortality and short- and long-term secondary outcomes will be performed. Pre-specified subgroup analyses will be performed according to the type of toxic alcohol intoxication, mode of renal replacement therapy, and medical interventions received. A meta-analysis will be performed if three or more studies with similar populations, type of toxic alcohol poisoning, and outcome measures, as well as adequate quality, are identified. This review will be reported according to the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Statement.
This systematic review aims to synthesize current evidence in the short- and long-term outcomes of post-toxic alcohol poisoning. The results will enhance the understanding of patient morbidity and mortality after toxic alcohol poisoning, help inform uniform concrete management guideline development, identify gaps in the current state of knowledge, and provide evidence to help implement post-treatment follow-up.
PROSPERO CRD42018101955.
有毒醇类已被认为与意外摄入和故意暴露有关。识别有毒醇中毒具有挑战性。主要的治疗方法包括使用乙醇脱氢酶抑制剂的解毒剂和透析。目前已有甲醇和乙二醇中毒的指南。然而，对于其他有毒醇中毒的治疗共识有限。此外，关于何时开始使用解毒剂和透析的阈值仍然存在不确定性。因此，对于所有有毒醇中毒的管理干预措施存在差异。据我们所知，目前尚无关于有毒醇中毒临床结局的系统评价。本研究的目的是总结目前关于甲醇、乙二醇、异丙醇、丙二醇和二甘醇中毒患者短期和长期结局的证据。
将根据预先确定的标准在 PubMed、MEDLINE 和 EMBASE 中进行文献检索。不限制出版日期或语言。将通过对合格研究的参考文献进行手动扫描和对灰色文献进行评估来补充检索。本综述将包括观察性研究和临床试验。一旦根据预先规定的标准选择了合格的研究，两名研究人员将独立提取相关数据，并根据验证工具进行质量评估。将对死亡率以及短期和长期次要结局进行汇总分析。将根据中毒类型、肾脏替代治疗方式和接受的医疗干预进行预先指定的亚组分析。如果确定了三个或更多具有相似人群、中毒类型和结局测量以及足够质量的研究，将进行 meta 分析。本综述将根据系统评价和荟萃分析的首选报告项目（PRISMA）声明的建议进行报告。
本系统评价旨在综合目前关于有毒醇中毒后短期和长期结局的证据。结果将提高对有毒醇中毒后患者发病率和死亡率的认识，有助于为统一的具体管理指南制定提供信息，确定当前知识状态的差距，并提供证据以帮助实施治疗后随访。
PROSPERO CRD42018101955。
