Extracorporeal treatment for tricyclic antidepressant poisoning: recommendations from the EXTRIP Workgroup.

Abstract:

:The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed in person at a meeting. A second vote determined the final recommendations. Seventy-seven articles met inclusion criteria. Only case reports, case series, and one poor-quality observational study were identified yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers that poisoned patients with TCAs are not likely to have a clinical benefit from extracorporeal removal and recommends it NOT to be used in TCA poisoning.

journal_name

Semin Dial

journal_title

Seminars in dialysis

authors

Yates C,Galvao T,Sowinski KM,Mardini K,Botnaru T,Gosselin S,Hoffman RS,Nolin TD,Lavergne V,Ghannoum M,EXTRIP workgroup.

doi

10.1111/sdi.12227

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

381-9

issue

4

eissn

0894-0959

issn

1525-139X

journal_volume

27

pub_type

杂志文章,评审
  • Niacin and related compounds for treating hyperphosphatemia in dialysis patients.

    abstract::Recent experimental and clinical studies suggest the possible utility of niacin (nicotinic acid, vitamin B3) and its metabolite nicotinamide as a means of lowering phosphate levels in dialysis patients via direct inhibition of the Na-Pi-2b sodium-dependent phosphate co-transporter in the GI tract. While the possibilit...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2008.00426.x

    authors: Berns JS

    更新日期:2008-05-01 00:00:00

  • Transplantation in diabetic kidney failure patients: modalities, outcomes, and clinical management.

    abstract::Diabetes mellitus (DM) is a common and devastating disease, affecting up to 19.3 million Americans. It is the leading cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) in the United States. Diabetic patients with ESRD have a high incidence of cardiovascular disease and death. For those kidney tr...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2010.00708.x

    authors: Luan FL,Samaniego M

    更新日期:2010-03-01 00:00:00

  • Short daily hemodialysis and nutritional status in patients with chronic renal failure.

    abstract::Malnutrition is a frequent complication in hemodialysis patients and is associated with increased mortality and morbidity. Interventions such as oral or intravenous nutritional supplements have often failed to improve nutritional status. We report here the effect that daily dialysis, practiced in our center since 1997...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.0894-0959.2004.17205.x

    authors: Galland R,Traeger J

    更新日期:2004-03-01 00:00:00

  • Inadequate treatment of congestive heart failure in dialysis patients.

    abstract::Congestive heart failure (CHF) is highly prevalent in patients on renal replacement therapy and is a leading cause of death in such patients. Several studies suggest that therapeutic agents for the treatment of CHF, particularly angiotensin converting enzyme inhibitors and beta-blockers, are underused in end-stage ren...

    journal_title:Seminars in dialysis

    pub_type: 社论

    doi:10.1111/j.1525-139X.2007.00313.x

    authors: Bouchard J,Madore F

    更新日期:2007-09-01 00:00:00

  • Beta blockers in patients with end-stage renal disease-Evidence-based recommendations.

    abstract::For patients who require hemodialysis, beta blockers offer a simultaneous opportunity and challenge in the treatment of cardiovascular disease. Beta blockers are well supported by data from nondialysis populations and directly mitigate the sympathetic overactivity that links chronic kidney disease with cardiovascular ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12691

    authors: Weir MA,Herzog CA

    更新日期:2018-05-01 00:00:00

  • Epidemiology and demographic aspects of treated end-stage renal disease in the elderly.

    abstract::Over the last 10 years an increasing number of patients worldwide have started dialysis or had transplantation. Many are elderly with complex comorbid conditions. Registries across the world all show a rapid and dramatic increase in the number of older patients accepted for renal replacement therapy. In addition, the ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1046/j.1525-139x.2002.00028.x

    authors: Krishnan M,Lok CE,Jassal SV

    更新日期:2002-03-01 00:00:00

  • Inflammatory biomarkers and cardiovascular risk: association or cause and effect?

    abstract::With the current understanding that atherosclerosis is an inflammatory disorder, markers of the associated systemic inflammatory response have been extensively studied as predictors of cardiovascular disease. Recently the use of high-sensitivity C-reactive protein (hsCRP) has been proposed for risk assessment in indiv...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2006.00138.x

    authors: Rao M,Jaber BL,Balakrishnan VS

    更新日期:2006-03-01 00:00:00

  • The impact of dialysis modality and membrane characteristics on intradialytic hypotension.

    abstract::The risk of intradialytic hypotension (IDH) is determined by various factors, among them dialysis modality and dialyzer membrane. We conducted a literature search in PubMed on November 1, 2016 and selected relevant randomized controlled and cross-over trials, and prospective and retrospective cohort studies published ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12636

    authors: Patel S,Raimann JG,Kotanko P

    更新日期:2017-11-01 00:00:00

  • The effect of chronic renal failure on hepatic drug metabolism and drug disposition.

    abstract::There is abundant evidence that chronic renal failure (CRF) and end-stage renal disease (ESRD) alter drug disposition by affecting protein and tissue binding and reducing systemic clearance of renally cleared drugs. What is not fully appreciated is that CRF can significantly reduce nonrenal clearance and alter the bio...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1046/j.1525-139x.2003.03011.x

    authors: Dreisbach AW,Lertora JJ

    更新日期:2003-01-01 00:00:00

  • ESRD-induced dyslipidemia-Should management of lipid disorders differ in dialysis patients?

    abstract::Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Although numerous modifiable risk factors in the pathogenesis of CVD and its associated mortality have been identified, dyslipidemia remains to be a key focus for therapy. In this regard, significant progress has been made in reducing ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12706

    authors: Moradi H,Streja E,Vaziri ND

    更新日期:2018-07-01 00:00:00

  • Longitudinal assessment of hemodynamic endpoints in predicting arteriovenous fistula maturation.

    abstract::Arteriovenous fistula (AVF) nonmaturation is currently a significant clinical problem; however, the mechanisms responsible for this have remained unanswered. Previous work by our group and others has suggested that anatomical configuration and the corresponding hemodynamic endpoints could have an important role in AVF...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2012.01112.x

    authors: Rajabi-Jagahrgh E,Krishnamoorthy MK,Roy-Chaudhury P,Succop P,Wang Y,Choe A,Banerjee RK

    更新日期:2013-03-01 00:00:00

  • The relation between epicardial fat tissue thickness and atrial fibrillation ın hemodialysis patients.

    abstract::The prevalence of arrhythmia has increased in hemodialysis (HD) patients and the most frequent is atrial fibrillation (AF). It was reported that the amount of epicardial fat tissue (EFT) in the population without renal disease is closely related to AF. In the present study of ours, the relation between EFT thickness a...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12901

    authors: Guzel FB,Altunoren O,Gunes H,Seyithanoglu M,Kerkutluoglu M,Sezal DT,Gungor O

    更新日期:2020-09-01 00:00:00

  • Euvolemia-A critical target in the management of acute kidney injury.

    abstract::It has been clearly established that critically ill patients with sepsis require prompt fluid resuscitation. The optimal amount of fluid and when to taper this resuscitation is less clear. There is a growing evidence that fluid overload leads to acute kidney injury, and increased morbidity and mortality. A clinician's...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1111/sdi.12753

    authors: Colbert GB,Szerlip HM

    更新日期:2019-01-01 00:00:00

  • Unrecognized high brachial artery bifurcation is associated with higher rate of dialysis access failure.

    abstract::A thorough consideration of all factors contributing to successful dialysis access creation is necessary to achieve optimal outcomes. A high bifurcation of the brachial artery (brachioradial variant) occurs in greater than 20% of patients. Dialysis access was created in 22 limbs with this variant--15 fistula, and 7 pr...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,收录出版

    doi:10.1111/j.1525-139X.2011.00923.x

    authors: Kirksey L

    更新日期:2011-11-01 00:00:00

  • Fragmentation of care as a barrier to optimal ESKD management.

    abstract::Caring for patients with end-stage kidney disease (ESKD) in the United States is challenging, due in part to the complex epidemiology of the disease's progression as well as the ways in which care is delivered. As CKD progresses toward ESKD, the number of comorbidities increases and care involves multiple healthcare p...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12929

    authors: Sloan CE,Zhong J,Mohottige D,Hall R,Diamantidis CJ,Boulware LE,Wang V

    更新日期:2020-11-01 00:00:00

  • The use of iodinated contrast media in patients with end-stage renal disease.

    abstract::Iodinated contrast agents are well tolerated in ESRD patients. Certain types of ICM, i.e., LOCM and the nonionic agents are associated with better safety profiles. Current available evidence, although not optimal, does not support the need for additional hemodialysis for ICM removal to preserve residual renal function...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12268

    authors: Khan SF,Kalantari K

    更新日期:2014-11-01 00:00:00

  • Electrolyte disturbances in the intensive care unit.

    abstract::The development of many electrolyte disturbances in the ICU can be prevented by attention to the use of intravenous fluids and nutrition. Hyponatremia is a relative contraindication to the use of hypotonic intravenous fluids and hypernatremia calls for the administration of water. Formulae have been devised to guide t...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2006.00212.x

    authors: Sedlacek M,Schoolwerth AC,Remillard BD

    更新日期:2006-11-01 00:00:00

  • In-center hemodialysis education: Challenges and innovations in training of fellows in nephrology.

    abstract::The in-center dialysis unit and practice of dialysis, in the current multi-team approach, requires knowledge and skills in all the domains including medical expert, communicator, collaborator, scholar, health advocate, and leader. We are tasked as a community, to embrace and incentivize new innovations and technology ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/sdi.12668

    authors: Moist LM,Lindsay RM

    更新日期:2018-03-01 00:00:00

  • Association between CRT(D)/ICD and renal insufficiency: A systematic review and meta-analysis.

    abstract::Cardiac resynchronization therapy with or without a defibrillator (CRT(D)) and implantable cardioverter defibrillator (ICD) may reduce the risk of arrhythmia or heart failure-specific mortality and improves the prognosis of patients with chronic kidney disease (CKD) or dialysis. The aim of this study was to perform a ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12937

    authors: Liu Y,Sun JY,Zhu YS,Li ZM,Li KL,Wang RX

    更新日期:2020-12-09 00:00:00

  • Cerebral ischemia during hemodialysis-finding the signal in the noise.

    abstract::Hemodialysis patients have multiple risk factors for small vessel cerebrovascular disease and cognitive dysfunction. Hemodialysis itself may cause clinically significant neurological injury through repetitive cerebral ischemia. However, supporting evidence to date consists of epidemiological associations, expert opini...

    journal_title:Seminars in dialysis

    pub_type: 社论,评审

    doi:10.1111/sdi.12679

    authors: MacEwen C,Watkinson P,Tarassenko L,Pugh C

    更新日期:2018-05-01 00:00:00

  • Lipid abnormalities associated with end-stage renal disease.

    abstract::Patients undergoing chronic renal replacement therapy have a high incidence of dyslipidemia. In general, there are increased concentrations of triglyceride-rich apolipoprotein B-containing particles. These elevations lead to increased levels of non-high-density lipoprotein (HDL) levels. This pattern is further modifie...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2006.00117.x

    authors: Liu J,Rosner MH

    更新日期:2006-01-01 00:00:00

  • Conservative treatment of the uremic syndrome.

    abstract::In addition to extracorporeal renal replacement strategies, which in chronic kidney disease (CKD) are largely reserved for the treatment of end-stage kidney failure, conservative measures can be taken to reduce concentration, effects, or both concentration and effects of uremic retention solutes. In this overview, we ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2009.00600.x

    authors: Vanholder R,Argilés A,Beige J,Brunet P,Drüeke TB,Fliser D,Herget-Rosenthal S,Hörl WH,Jörres A,Perna A,Rodriguez-Portillo M,Spasovski G,Stegmayr B,Stenvinkel P,Wanner C,Wiecek A,Massy ZA

    更新日期:2009-07-01 00:00:00

  • The impact of arteriovenous fistulae on the myocardium: the impact of creation and ligation in the transplant era.

    abstract::Cardiac hypertrophy is a relatively common complication seen in patients with advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD). Moreover, cardiac hypertrophy is even more frequently seen in patients with ESRD who have an arteriovenous (AV) access. There has been substantial evidence pertaining ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12313

    authors: Duque JC,Gomez C,Tabbara M,Alfonso CE,Li X,Vazquez-Padron RI,Asif A,Lenz O,Briones PL,Salman LH

    更新日期:2015-05-01 00:00:00

  • We Underdose Antibiotics in Patients on CRRT.

    abstract::Appropriate antibiotic dosing in critically ill, infected, patients receiving continuous renal replacement therapy (CRRT) is crucial to improve patient outcomes. Severe sepsis and septic shock result in changes in pharmacokinetic parameters, including increased volume of distribution, hypoalbuminemia, and changes in r...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12496

    authors: Shaw AR,Chaijamorn W,Mueller BA

    更新日期:2016-07-01 00:00:00

  • Similar outcomes of catheters implanted by nephrologists and surgeons: analysis of the Brazilian peritoneal dialysis multicentric study.

    abstract::A good catheter implantation technique is important to allow for effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with surgeons have been limited to small single-center experiences. Thus, the objective of this study was to explore ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1525-139X.2012.01050.x

    authors: de Moraes TP,Campos RP,de Alcântara MT,Chula D,Vieira MA,Riella MC,Olandowski M,Divino-Filho JC,Pecoits-Filho R,Investigators of BRAZPD.

    更新日期:2012-09-01 00:00:00

  • Convective therapies for removal of middle molecular weight uremic toxins in end-stage renal disease: a review of the evidence.

    abstract::The increasing number of patients requiring renal replacement therapy poses a challenge to maintain quality of care in the setting of limited resources. The commonly used modalities include hemodialysis and peritoneal dialysis, and using a "urea-centric" model to increase the clearance of small molecular weight uremic...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2009.00665.x

    authors: Thomas G,Jaber BL

    更新日期:2009-11-01 00:00:00

  • Addressing myths about exercise in hemodialysis patients.

    abstract::Despite decades of research, there are few published guidelines related to the safety and efficacy of exercise training in hemodialysis patients. This has led to disparate recommendations regarding the type, intensity, and timing for exercise, especially for patients with multiple comorbidities. Many common recommenda...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12815

    authors: Wilund KR,Jeong JH,Greenwood SA

    更新日期:2019-07-01 00:00:00

  • Decreasing hospitalizations in patients on hemodialysis: Time for a paradigm shift.

    abstract::Hospitalizations drive up to 35% of the astronomical costs of care for patients on hemodialysis and are associated with poor outcomes. We describe outpatient care-sensitive categories of hospitalization risks in an effort to engage stakeholders and patients, as stakeholders, in mitigating hospitalizations. These categ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/sdi.12675

    authors: Golestaneh L

    更新日期:2018-05-01 00:00:00

  • Use of a covered stent in a failed forearm fistula as a present access and future bridge.

    abstract::The use of stents has been steadily increasing in the management of dialysis access dysfunction. The purpose of this report was to review the use of covered stents in failed forearm fistulas and describe a case of the use of a small caliber forearm covered stent in a early failed forearm fistula that allowed dialysis ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章

    doi:10.1111/j.1525-139X.2008.00473.x

    authors: Ross JL

    更新日期:2009-01-01 00:00:00

  • Clinical waste generation from renal units: implications and solutions.

    abstract::The treatment of end-stage renal disease (ESRD) makes extensive use of presterilized disposable items which, after use, are contaminated by blood. The preferred route of disposal of such items is by incineration. Disposal costs have risen and this increase in costs has not been matched by waste management programs in ...

    journal_title:Seminars in dialysis

    pub_type: 杂志文章,评审

    doi:10.1111/j.1525-139X.2005.00078.x

    authors: Hoenich NA,Levin R,Pearce C

    更新日期:2005-09-01 00:00:00