Document Detail


Extracorporeal Treatment for Tricyclic Antidepressant Poisoning: Recommendations from the EXTRIP Workgroup.
MedLine Citation:
PMID:  24712820     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Christopher Yates; Tais Galvao; Kevin M Sowinski; Karine Mardini; Tudor Botnaru; Sophie Gosselin; Robert S Hoffman; Thomas D Nolin; Valéry Lavergne; Marc Ghannoum
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-9
Journal Detail:
Title:  Seminars in dialysis     Volume:  -     ISSN:  1525-139X     ISO Abbreviation:  Semin Dial     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-4-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8911629     Medline TA:  Semin Dial     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 The Authors. Seminars in Dialysis published by Wiley Periodicals, Inc.
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