Krenzelok E P, McGuigan M, Lheur P
J Toxicol Clin Toxicol. 1997;35(7):699-709. doi: 10.3109/15563659709162567.
In preparing this Position Statement, all relevant scientific literature was identified and reviewed critically by acknowledged experts using agreed criteria. Well-conducted clinical and experimental studies were given precedence over anecdotal case reports and abstracts were not usually considered. A draft Position Statement was then produced and subjected to detailed peer review by an international group of clinical toxicologists chosen by the American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists. The Position Statement went through multiple drafts before being approved by the boards of the two societies and being endorsed by other societies. The Position Statement includes a summary statement for ease of use and is supported by detailed documentation which describes the scientific evidence on which the Statement is based. Syrup of ipecac should not be administered routinely in the management of poisoned patients. In experimental studies the amount of marker removed by ipecac was highly variable and diminished with time. There is no evidence from clinical studies that ipecac improves the outcome of poisoned patients and its routine administration in the emergency department should be abandoned. There are insufficient data to support or exclude ipecac administration soon after poison ingestion. Ipecac may delay the administration or reduce the effectiveness of activated charcoal, oral antidotes, and whole bowel irrigation. Ipecac should not be administered to a patient who has a decreased level or impending loss of consciousness or who has ingested a corrosive substance or hydrocarbon with high aspiration potential.
在编写本立场声明时，所有相关科学文献均由知名专家按照商定标准进行识别和严格审查。精心开展的临床和实验研究优先于轶事性病例报告，通常不考虑摘要。随后制定了立场声明草案，并由美国临床毒理学会和欧洲毒物中心及临床毒理学家协会挑选的一组国际临床毒理学家进行详细的同行评审。该立场声明经过多次草稿修改，才获得两个学会理事会的批准并得到其他学会的认可。立场声明包括一份便于使用的总结声明，并辅以详细文件，描述声明所依据的科学证据。吐根糖浆不应在中毒患者的治疗中常规使用。在实验研究中，吐根清除标记物的量变化很大，且会随时间减少。临床研究中没有证据表明吐根能改善中毒患者的预后，应放弃在急诊科常规使用吐根。没有足够的数据支持或排除在摄入毒物后不久使用吐根。吐根可能会延迟活性炭、口服解毒剂和全肠灌洗的使用或降低其有效性。不应给意识水平降低或即将失去意识的患者、或摄入有高误吸风险的腐蚀性物质或碳氢化合物的患者使用吐根。
