Episode #9: TPR Podcast on hemodialysis in poisonings
Episode 9: EXTRIP Review
Written by Theresa Kim, MD
Outline
EXTRIP Guideline Methodology
Methanol
Theophylline
Lithium
Acetaminophen
EXTRIP Guideline Methodology
Extracorporeal treatments (ie. hemodialysis, hemoperfusion) are commonly used in poisonings despite lack of formal human trials
Goal of the EXTRIP workgroup was to form an international collaboration among experts from nephrology, toxicology, critical care, pharmacology, and over 30 professional societies to form consensus recommendations and suggestions based on available research and expert opinion
Clinical evidence ranked using GRADE system A-D
A = high quality evidence
D = very poor quality evidence
Strength of consensus recommendations ranked on a 3 level scale:
Level 1: strong recommendation agreed upon by large majority of experts
Level 2: weak recommendation considered appropriate by majority of experts but with some disagreement
Level 3: neutral position considered appropriate in right context
NOTE: The following are summaries of the key points from the ExTRIP publications. For a more complete discussion of the group’s full recommendations and suggestions, follow links from the ExTRIP website.
Methanol
ECTR recommended in the following circumstances
Severe methanol poisoning (coma, seizure, vision deficits, metabolic acidosis pH<7.15, persistent acidosis, AND/OR anion gap > 24 mmol/L (1D)
Serum methanol concentrations
>70mg/dL in context of fomepizole therapy...
Source: The Poison Review - Category: Toxicology Authors: LeonThe Poison Review Tags: Podcast Source Type: news
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