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Title: | Efficacy of fresh frozen plasma transfusion in comparison with conventional regimen in organophosphate poisoning treatment: a meta-analysis study. | Austin Authors: | Gheshlaghi, Farzad;Akafzadeh Savari, Mahsa;Nasiri, Rozita;Wong, Anselm Y ;Feizi, Awat;Reza Maracy, Mohammad;Dorooshi, Gholamali;Meamar, Rokhsareh;Eizadi-Mood, Nastaran | Affiliation: | Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Centre for Integrated Critical Care, Department of Medicine and Radiology, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia Victorian Poisons Information Centre Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia Department of Epidemiology & Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Toxicology Emergency |
Issue Date: | Sep-2020 | Date: | 2020-10-16 | Publication information: | Critical Reviews in Toxicology 2020; 50(8): 677-684 | Abstract: | To evaluating the efficacy of fresh frozen plasma (FFP) in comparison with conventional regimen in the treatment of organophosphate (OP) poisoning. PubMed, ScopeMed, Cochrane, Scopus, and Google Scholar databases were searched. The search strategy used the following key words "organophosphate" and "poisoning or toxicity", "(atropine and oxime)", "fresh frozen plasma", "clinical trial", "outcome". The treatment with atropine or/and oxime was considered conventional therapy. The length of hospitalization, the length of ICU admission, need for mechanical ventilation and its duration, clinical recovery point, choline esterase level, mortality rate, and intermediate syndrome (IMS) occurrence were the key outcomes of interest. Databases were searched during the period of 2003-2019. Five studies were included in the analysis. Pooling of data showed that the relative risk (RR) of mortality in OP poisoning for five included trials comparing FFP-treated group with conventional regimen therapy was [0.563 (95% CI (0.252, 1.255)]. The summary of RR for IMS in two studies was [RR: 1.34, 95% CI (0.655, 2.742)]. In addition, there was a non-significant mean difference (MD) in hospital stay [MD: -0.106, 95% CI (-0.434, 0.223)] in three included trials. A significant MD was observed in the length of ICU admission in two trials between FFP-treated group compared to the conventional treatment group [MD: -2.672, 95% CI (-4.189, -1.154)], but after random effects meta-analysis, the changes were not significant [MD: -2.015, 95% CI (-6.308, 2.277)]. The summary of fixed-effect meta-analysis for choline esterase level in three trails was [MD: -0.117, 95% CI (-0.468, 0.234)]. The RR of ventilation requirement for two included trials in the FFP-treated group comparing to the conventional regimen therapy was [0.84, 95% CI (0.691, 1.022)] while for ventilation duration in two studies was [MD: -0.183, 95% CI (-0.567, 0.201)]. The addition of FFP to conventional therapy did not improve the outcomes of mortality, IMS, hospital length of stay, cholinesterase levels, need or duration of mechanical ventilation, and only the length of ICU stay could affect in the treated group. | URI: | https://ahro.austin.org.au/austinjspui/handle/1/25156 | DOI: | 10.1080/10408444.2020.1823313 | ORCID: | 0000-0002-8972-7366 0000-0003-4298-0257 0000-0002-3897-8034 0000-0002-6817-7289 0000-0002-1930-0340 0000-0002-3695-0863 0000-0003-2552-0961 0000-0002-4536-5113 0000-0001-9792-8160 |
Journal: | Critical Reviews in Toxicology | PubMed URL: | 33064048 | Type: | Journal Article | Subjects: | Organophosphate poisoning atropine clinical trials fresh frozen plasma outcome oximes |
Appears in Collections: | Journal articles |
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