Meta-analysis of the safety and efficacy of fresh frozen plasma exchange in the treatment of organophosphate pesticide poisoning.

Abstract

This study evaluates whether fresh frozen plasma (FFP) improves outcomes compared to conventional therapy alone in organophosphorus poisoning (OP). Relevant literature was searched in PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, and VIP databases, applying predefined inclusion/exclusion criteria to select studies. Data from included studies were extracted for analysis. Seven randomized clinical trials involving 391 patients were included in the analysis, with 191 patients in the FFP combined with conventional therapy group (combination therapy group) and 200 patients in the conventional therapy alone group (control group). Compared with the control group, the combination therapy group demonstrated a lower case fatality rate (relative risk (RR) = 0.58, 95% confidence interval [CI] [0.34, 0.97], p < .05), reduced utilization of mechanical ventilation (RR = 0.78, 95% CI [0.64, 0.95], p < .05), and superior cholinesterase recovery levels (standardized mean difference (SMD) = 1.70, 95% CI [-0.02, 3.43], p = .05). However, no significant differences were observed between the two groups in hospitalization duration or ICU length, incidence of intermediate syndrome, and duration of mechanical ventilation maintenance (p > .05). Current evidence indicates that FFP combined with conventional therapy may reduce mortality rates, mechanical ventilation utilization, and enhance cholinesterase activity recovery levels in OP patients. Nevertheless, multicenter randomized double-blind controlled trials remain necessary to validate these findings in the future.