Eriyawa Asanka, Jayamanne Shaluka, Lokunarangoda Niroshan, Pathmeswaran Arunasalam, Francis Rajeevan, Arulnithy Kanagasingam, Dharmapala Dinuka, Jayawardane Pradeepa
Department of Pharmacology, Faculty of Medicine, Wayamba University of Sri Lanka, Kuliyapitiya, Sri Lanka.
Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka.
PLoS One. 2025 Mar 25;20(3):e0320301. doi: 10.1371/journal.pone.0320301. eCollection 2025.
Yellow oleander (Cascabela thevetia, previously known as Thevetia peruviana) & Common oleander (Nerium oleander) contain a wide range of cardiac glycosides and their toxicity is similar to digoxin toxicity. It causes arrhythmogenesis by directly and indirectly influencing cardiac myocytes. Oleander poisoning leads to high morbidity and mortality, causing considerable healthcare burden worldwide. This systematic review and meta-analysis aim to synthesize evidence from studies reporting the effects of electrocardiographic and biochemical changes following acute oleander toxicity. It will contribute to identifying the true incidence of electrocardiographic and electrolyte changes which will be useful in-patient management and clinical decisions. Electronic databases, Google Scholar, and reference lists of relevant articles will be searched. Human studies reporting electrolyte and electrocardiographic changes following acute yellow oleander and common oleander toxicity globally from 1988 onwards will be included. The eligibility of studies will be checked by two reviewers independently, and the risk of bias will be evaluated for each study using the JBI critical appraisal tool. The Rayyan software will be used for the systematic review while heterogeneity of studies will be assessed using I2 statistics. In the case of I2 > 50%, meta-analysis will be conducted using a random effects model using STATA software. Publication bias will be assessed using visual inspection of funnel plots & Egger's weighted regression. The incidence of electrocardiographic and biochemical changes following oleander poisoning will directly influence patient management and guide improvements in healthcare facilities. Although ethical approval is not required for the systematic review, it will be disseminated through peer-reviewed publications, index journals, and scientific conferences. PROSPERO registration PROSPERO registration number for this protocol is CRD42023451171.
黄花夹竹桃（黄花夹竹桃属，以前称为秘鲁黄花夹竹桃）和夹竹桃（欧洲夹竹桃）含有多种强心苷，其毒性与地高辛中毒相似。它通过直接和间接影响心肌细胞而导致心律失常。夹竹桃中毒导致高发病率和死亡率，在全球范围内造成相当大的医疗负担。本系统评价和荟萃分析旨在综合报告急性夹竹桃中毒后心电图和生化变化影响的研究证据。这将有助于确定心电图和电解质变化的真实发生率，这对患者管理和临床决策很有用。将检索电子数据库、谷歌学术以及相关文章的参考文献列表。将纳入自1988年以来全球范围内报告急性黄花夹竹桃和夹竹桃中毒后电解质和心电图变化的人体研究。研究的合格性将由两名评审员独立检查，每项研究的偏倚风险将使用JBI批判性评价工具进行评估。将使用Rayyan软件进行系统评价，同时使用I2统计量评估研究的异质性。如果I2>50%，将使用STATA软件的随机效应模型进行荟萃分析。将通过漏斗图的视觉检查和Egger加权回归评估发表偏倚。夹竹桃中毒后心电图和生化变化的发生率将直接影响患者管理并指导医疗设施的改进。虽然系统评价不需要伦理批准，但将通过同行评审出版物、索引期刊和科学会议进行传播。PROSPERO注册 本方案的PROSPERO注册号为CRD42023451171。
