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

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