The frequency of complications associated with the use of multiple-dose activated charcoal
The frequency of complications associated with the use of multiple-dose activated charcoal
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DOI：
10.1067/mem.2003.86
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发表时间：
2003-03-01
影响因子：
6.2
通讯作者：
Brant, R
中科院分区：
文献类型：
--
作者：
Dorrington, CL;Johnson, DW;Brant, R
研究目的：本研究的目的是确定与使用多剂量活性炭相关的并发症的频率。方法：研究人群来自北美4个城市的8所三级医院。审查了1993年3月至1998年3月期间出院诊断为中毒的所有住院患者的医疗记录（《国际疾病分类》第9版，临床修改代码960-989.9），以选择接受多剂量活性炭（定义为在12小时内给予大于或等于2剂量）的患者。我们回顾了使用多剂量活性炭的患者的医疗记录，以了解患者的人口统计学和临床信息，包括肺误吸、胃肠道梗阻、高钠血症、高镁血症、角膜磨损和其他与使用多剂量活性炭相关的并发症。结果：我们回顾了6258份医疗记录，确定了878名接受多剂量活性炭治疗的患者。我们判断5例（0.6%；95%置信区间[Cl] 0.1%至1.1%）患者有临床意义的肺误吸，无一例（0%；95%置信区间上限[Cl] 0.3%）患者有胃肠道梗阻。所有肺误吸患者均无死亡及后遗症记录。53例（6.0%;95% Cl 4.4% ~ 7.6%）患者出现高钠血症（峰值血清钠bb0 145 mEq/L [145 mmol/L]），其中5例（0.6%;95% Cl 0.1% ~ 1.1%）患者血清钠浓度大于155 mEq/L （155 mmol/L）。27例（3.1%;95% Cl 2.0% ~ 4.2%）患者出现高镁血症（峰值血清镁>2.5 mg/dL [1.0 mmol/L]），其中3例（0.3%;95% Cl 0.1% ~ 1.0%）的峰值大于3.75 mg/dL （1.5 mmol/L）。1例患者角膜磨损（0.1%;95% Cl 0% ~ 0.6%）。未发现其他并发症。结论：多剂量活性炭的临床并发症发生率较低。
Study objective: The objective of this study was to determine the frequency of complications associated with the use of multiple-dose activated charcoal.Methods: The study population was drawn from 8 tertiary care hospitals in 4 North American cities. Medical records of all inpatients between March 1993 and March 1998 with a discharge diagnosis of poisoning (International Classification of Diseases, 9th edition, Clinical Modification codes 960-989.9) were reviewed to select patients who had received multiple-dose activated charcoal (defined as greater than or equal to2 doses administered within 12 hours). Medical records of patients who received multiple-dose activated charcoal were reviewed for patient demographics and clinical information regarding the occurrence of pulmonary aspiration, gastrointestinal obstruction, hypernatremia, hypermagnesemia, corneal abrasion, and other complications associated with the use of multiple-dose activated charcoal.Results: We reviewed 6,258 medical records, identifying 878 patients who received multiple-dose activated charcoal. We judged 5 (0.6%; 95% confidence interval [Cl] 0.1% to 1.1%) patients to have had clinically significant pulmonary aspiration and none (0%; upper 95% Cl 0.3%) to have had gastrointestinal obstruction. None of the patients with pulmonary aspiration died or had residual sequelae recorded. Hypernatremia (peak serum sodium >145 mEq/L [145 mmol/L) was documented in 53 (6.0%; 95% Cl 4.4% to 7.6%) patients, of whom 5 (0.6%; 95% Cl 0.1% to 1.1%) had a serum sodium concentration of greater than 155 mEq/L (155 mmol/L). Hypermagnesemia (peak serum magnesium >2.5 mg/dL [1.0 mmol/L]) was documented in 27 (3.1%; 95% Cl 2.0% to 4.2%) patients, of whom 3 (0.3%; 95% Cl 0.1% to 1.0%) had peak values that were greater than 3.75 mg/dL (1.5 mmol/L). One patient had a corneal abrasion (0.1%; 95% Cl 0% to 0.6%). No other complications were identified.Conclusion: Clinically significant complications associated with the use of multiple-dose activated charcoal occur infrequently.