Systematic review on the use of activated charcoal for gastrointestinal decontamination following acute oral overdose
| Autor: | David M. Wood, Silas W. Smith, E. Martin Caravati, Lotte C. G. Hoegberg, Kent R. Olson, Jami Johnson, Robert S. Hoffman, Sophie Gosselin, Wui Ling Chan, Greene Shepherd |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Acute overdose business.industry Pillar General Medicine equipment and supplies Toxicology Gastrointestinal decontamination Carbamazepine Activated charcoal Charcoal visual_art visual_art.visual_art_medium medicine Animals Humans sense organs Drug Overdose Intensive care medicine business Decontamination Acetaminophen |
| Zdroj: | Clinical Toxicology. 59:1196-1227 |
| ISSN: | 1556-9519 1556-3650 |
| DOI: | 10.1080/15563650.2021.1961144 |
| Popis: | The use of activated charcoal in poisoning remains both a pillar of modern toxicology and a source of debate. Following the publication of the joint position statements on the use of single-dose and multiple-dose activated charcoal by the American Academy of Clinical Toxicology and the European Association of Poison Centres and Clinical Toxicologists, the routine use of activated charcoal declined. Over subsequent years, many new pharmaceuticals became available in modified or alternative-release formulations and additional data on gastric emptying time in poisoning was published, challenging previous assumptions about absorption kinetics. The American Academy of Clinical Toxicology, the European Association of Poison Centres and Clinical Toxicologists and the Asia Pacific Association of Medical Toxicology founded the Clinical Toxicology Recommendations Collaborative to create a framework for evidence-based recommendations for the management of poisoned patients. The activated charcoal workgroup of the Clinical Toxicology Recommendations Collaborative was tasked with reviewing systematically the evidence pertaining to the use of activated charcoal in poisoning in order to update the previous recommendations.The main objective was: Does oral activated charcoal given to adults or children prevent toxicity or improve clinical outcome and survival of poisoned patients compared to those who do not receive charcoal? Secondary objectives were to evaluate pharmacokinetic outcomes, the role of cathartics, and adverse events to charcoal administration. This systematic review summarizes the available evidence on the efficacy of activated charcoal.A medical librarian created a systematic search strategy for Medline (Ovid), subsequently translated for Embase (From 22,950 titles originally identified, the final data set consisted of 296 human studies, 118 animal studies, and 145This systematic review found heterogenous data. The higher GRADE data was focused on a few select poisonings, while studies that addressed patients with unknown and or mixed ingestions were hampered by low rates of clinically meaningful toxicity or death. Despite these limitations, they reported a benefit of activated charcoal beyond one hour in many clinical scenarios. |
| Databáze: | OpenAIRE |
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