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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
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.
DOI: 10.1080/10408444.2020.1823313
ORCID: 0000-0002-8972-7366
Journal: Critical Reviews in Toxicology
PubMed URL: 33064048
Type: Journal Article
Subjects: Organophosphate poisoning
clinical trials
fresh frozen plasma
Appears in Collections:Journal articles

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