Efficacy and outcomes of lipid resuscitation on organophosphate poisoning patients: A systematic review and meta-analysis
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摘要Objective: Organophosphate (OP) pesticides are still widely available in developing countries, leading to numerous accidental or suicidal poisonings every year. Lipid emulsion treatments are commonly used in resuscitating OP poisoning patients but few studies regarding their use have been reported. Our meta-analysis aimed to analyze the efficacy and outcomes of lipid resuscitation on OP poisoning patients.

Methods: A systematic search for associated studies was conducted in Pubmed, EMBASE, MEDUNE, the Cochrane Library and the Chinese National Knowledge Infrastructure. Collected data was pooled using Revman v5.3. Outcomes included prognosis (cured vs. mortality rates), hepatic function (serum ALT, AST, Total Bilirubin (TBIL) level), serum acetylcholinesterase (AchE) level and respiratory function (rate of respiratory muscular paralysis).

Results: Seven randomized controlled studies consisting of 630 patients meeting inclusion criteria were identified. Lipid emulsion helped to improve the cure rate [OR = 2.54,95% CI (1.33, 4.86), p = 0.005] and lower the mortality rate [OR = 0.31, 95% CI (0.13, 0.74), p = 0.009]. Serum ALT, AST and TBIL in patients undergoing lipid resuscitation were lower than those in the control groups [ALT, SMD = -1.52, 95% CI (-2.64, 0.40), p = 0.008; AST, SMD = -1.66, 95% CI (-3.15, 0.16), p = 0.03; TBIL, SMD -1.26, 95% CI (-2.32, 0.20), p 0.02]. Serum AchE level were increased in patients treated with lipid emulsion [SMD = 2.15, 95% CI (1.60, 2.71), p < 0.00001]. Rate of respiratory muscular paralysis was lower in patients undergoing lipid resuscitation than those in the control groups [OR = 0.19, 95% CI (0.05. 0.71), p = 0.01].

Conclusion: Based on our meta-analysis of included RCT reports, lipid resuscitation seems likely to help improve prognosis and liver function of OP poisoning patients. However, larger multi-center RCTs are still recommended.
著者S Yu, S Yu, L Zhang, Y Gao, J Walline, X Lu, Y Ma, H Zhu, X Yu, Y Li
期刊名稱American Journal of Emergency Medicine
出版年份2019
月份9
卷號37
期次9
出版社WB Saunders
頁次1611 - 1617
國際標準期刊號0735-6757
電子國際標準期刊號1532-8171
語言美式英語

上次更新時間 2020-23-10 於 02:43