Meta AnalysisID 6967
油剂洗胃在磷化铝中毒中的应用：系统评价与Meta分析
CRD42023417503
The research question is structured according to the PICOT criteria (Richardson 1995) : -Population: patients of any age with acute ALP poisoning, admitted to health institutions within the first 6 h post-ingestion -Inte
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Record Fields
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- Meta Analysis Id
- 6967
- Evidence Id
- 15525
- Core Evidence Id
- 15525
- Source Meta Analysis Id
- 6948
- Herb2 Meta Analysis Id
- HBMA006948
- Crd Id
- CRD42023417503
- Title
- Oil-based gastric lavage in aluminum phosphide poisoning: a systematic review and meta-analysis
- Review Question
- The research question is structured according to the PICOT criteria (Richardson 1995) : -Population: patients of any age with acute ALP poisoning, admitted to health institutions within the first 6 h post-ingestion -Intervention: oil-based gastric lavage with liquid paraffin, coconut oil, almond oil, olive oil, or corn oil, through a nasogastric tube or orally administered. -Comparator: standard supportive measures tailored according to the patient’s condition -Outcomes: Primary Outcomes .All-cause mortality Secondary Outcomes ∙Duration of hospital stays ∙Need and duration of mechanical ventilation ∙Need for vasopressors ∙Adverse Events (AEs) due to the intervention -Time: Trials with at least 6 weeks of follow-up duration
- Study Type Included
- We plan to include randomized control trials (RCTs) of at least 6 weeks of overall study duration, evaluating oil-based orogastric lavage in patients with ALP poisoning, compared with placebo, standard care alone, or any other therapy in addition to standard care. -Inclusion criteria: articles with original data from RCT examining the use of oil-based orogastric lavage for treatment of people with ALP poisoning. The search won`t be restricted by language or status of publication -Exclusion criteria: a) repetitive data b) old published data for the same study c) unavailability of the complete report for reference in case of lack of clarity of information in the abstract d) Case series e) Case reports f) Nonsystematic reviews g) Editorials h) Letters to the editor
- Condition Being Studied
- Deliberate exposure to pesticides is one of the most common methods of suicide in LMICs, accounting for approximately 110, 000–168, 000 deaths per year, representing 14-20% of suicides globally. Fatal cases due to intentional exposure to Aluminum Phosphide (ALP) exceed 50%, which is comparable to other highly lethal suicide methods, such as firearms, used in high-income countries. Commonly known as rice tablet or wheat pill, ALP is a dark gray or yellow inorganic crystalline compound with garlic, fish, or raw liver odor, available as a tablet or pellet bag. It`s used as a rodenticide, insecticide, and fumigant, to protect grain stored in silos or in ship holds during transportation. Although it is stable when dry, in contact with moisture or acids, it is hydrolyzed to phosphine (PH₃, hydrogen phosphide, phosphorus trihydride), a highly toxic gas. After ingestion, hydrochloric acid (HCL) causes a more vigorous release of PH₃, which is rapidly absorbed through the gastrointestinal mucosa. Gastric lavage with potassium permanganate (KMnO4) or magnesium sulfate (MgSO4), the use of sodium bicarbonate (NaHCO3) or activated charcoal, has been used for many years, with a low level of certainty about its evidence. These strategies involve aqueous solutions which could induce more PH₃ liberation.
- Participant
- - Inclusion criteria: Any person presented within 6 hours post-exposure to ALP. Also, studies that were developed in health centers of any level of care in the inpatient setting were included. -Exclusion criteria: Studies that enrolled patients who presented with a delay time greater than 6 hs after ALP exposure or hose that took place in the outpatient setting were excluded.
- Animal
- Human Disease Modelled
- Intervention
- Inclusion criteria: Lavage solution with oils, including liquid paraffin, coconut oil, olive oil, almond oil, or corn oil, that was given through the nasogastric tube or orally administered, in any dosage schedule, as monotherapy, or in combination with another pharmacotherapy such as KMnO4, MgSO4, NaHCO3, or activated charcoal, if these interventions were provided equally in the experimental and control groups. Exclusion criteria: Lavage solution with any drugs not listed in the PICOT above
- Comparator Control
- Inclusion criteria: Placebo, any other pharmacotherapy and/or standard care available for the treatment of people with ALP poisoning Exclusion criteria: No comparison; non-concordant historical controls
- Main Outcome
- Primary outcomes -Mortality: percentage of death and survival within each group Secondary outcomes ∙Duration of hospital stays: mean of total hospital or ICU stay (hours) ∙Need and duration of mechanical ventilation: indication of endotracheal intubation / mechanical ventilation, and length (hours) ∙Need for vasopressors: administration of vasopressors or inotropic drugs. ∙Adverse Events (AEs) due to the intervention Measures of effect We will follow the intention-to-treat (ITT) principle, to assess the effect of intervention allocation, and maintains the benefit of the randomization, regardless of whether the interventions are received as intended. Dichotomous outcomes were analyzed by risk ratio calculation (RR), while for continuous outcomes we estimated the mean difference (MD). For each summary measure, we calculate its corresponding confidence interval of 95% (IC 95%). We will use the standardized mean difference (SMD) when studies used different instruments. As an absolute measure, the Number Needed to Treat (NNT) will be determined as the inverse of the Absolute Risk Reduction (1/ARR) We consider the possibility and implications of skewed data when analyzing continuous outcomes, particularly in small sample trials, where the true distribution may be asymmetrical
- Outcome Measure
- Additional Outcome
- Not applicable
- Study Method
- Meta-analysis, Systematic review
- Keyword
- Coconut Oil; Corn Oil; Eating; Follow-Up Studies; Humans; Infant; Mineral Oil; Olive Oil; Paraffin; Prunus dulcis; Respiration, Artificial; Therapeutic Irrigation; aluminum phosphide
- Contact
- Omar De Santi [email protected]
- Organisational Affiliation
- Hospital Nacional Profesor Alejandro Posadas-Centro Nacional de Intoxicaciones [email protected]
- Funding Source
- None Grant number(s) State the funder, grant or award number and the date of award None
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Not applicable
- Published Protocol
- Review Type
- Language
- English
- Country
- Argentina
- Review Stage
- Review Ongoing
- First Submission Date
- 2023-04-15
- Registration Date
- 2023-04-26
- Anticipated Start Date
- 2023-04-22
- Anticipated Completion Date
- 2023-08-26
- Title Cn
- 油剂洗胃在磷化铝中毒中的应用：系统评价与Meta分析
- Title En
- Oil-based gastric lavage in aluminum phosphide poisoning: a systematic review and meta-analysis
- Bilingual Status
- complete