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2.5 out of 5 stars Evaluation of Residual Toxic Substances in the Stomach Using Upper Gastrointestinal Endoscopy for Management of Patients With Oral Drug Overdose on Admission. Miyauchi M et al. Medicine 2015 Jan;94:e463 Abstract Despite many flaws, this paper has some interesting data that the authors use to come to exactly the wrong conclusion. The authors studied patients presenting with oral non-liquid drug overdose. Using endoscopy they classified the contents of the stomach as: 1) tablet/food phase; 2) soluble/fluid phase; and 3) reticular/empty phase.(I’m not clear on the precise meaning of a “tablet/food phase,” but let that pass.) They then compare these findings to the time elapsed rom ingestion, which they claim they determined with precision without revealing exactly how this was accomplished. They studied 167 patients. Their key finding was that only 12 of 73 patients (16%) with stomach contents in the tablet/food phase presented within 1 hour of ingestion; 3 of these patients actually presented more than 12 hours of the time of ingestion. The authors note that recent guidelines recommend that gastric lavage should not be performed routinely, but could be considered in a patient presenting less than one hour from an acute overdose. They argue that their results showing residual stomach contents more than 1 hour out for ingestion suggest that ” . . . the time that has elapsed since ingestion should not be a priority consideration when de...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical gastric empyting gastric lavage gastrointestinal decontamination Source Type: news