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- Title
Extracorporeal Treatment for Tricyclic Antidepressant Poisoning: Recommendations from the EXTRIP Workgroup.
- Authors
Yates, Christopher; Galvao, Tais; Sowinski, Kevin M.; Mardini, Karine; Botnaru, Tudor; Gosselin, Sophie; Hoffman, Robert S.; Nolin, Thomas D.; Lavergne, Valéry; Ghannoum, Marc
- 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.
- Subjects
POISONING; HEMODIALYSIS; TRICYCLIC antidepressants; RESEARCH teams; PUBLISHED articles; THERAPEUTICS
- Publication
Seminars in Dialysis, 2014, Vol 27, Issue 4, p381
- ISSN
0894-0959
- Publication type
Article
- DOI
10.1111/sdi.12227