扑热息痛(醋氨酚)中毒;中毒类型和结果的共识定义将用于临床毒理学建议协作系统评价。

IF 3 3区 医学 Q2 TOXICOLOGY
Clinical Toxicology Pub Date : 2025-05-01 Epub Date: 2025-03-31 DOI:10.1080/15563650.2025.2479721
Angela L Chiew, David M Wood, Dazhe Cao, Adam Overberg, Katrin Faber, Anselm Wong, Ruben Thanacoody, Adam C Pomerleau, Sophie Gosselin, Ashish Bhalla, Davide Lonati, D Nicholas Bateman
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引用次数: 0

摘要

扑热息痛(对乙酰氨基酚)中毒是常见的,许多出版物描述了各种结果和治疗方法。由于国际上没有一致的定义来描述扑热息痛过量的模式(急性、重复超治疗、慢性或交错),因此很难分析研究之间的结果。临床毒理学建议协作组的任务是为扑热息痛中毒的管理提供指导,并成立了扑热息痛工作组。工作组的结论是,需要一套商定的条款来进行系统审查和对证据进行分类。方法:采用改进的德尔菲法对扑热息痛的不同用药模式进行统一定义。结果:小组对每一种中毒模式的以下标准定义达成共识:急性、交错、重复超治疗摄入和慢性,用于即将进行的系统评价。“急性”摄入是指在少于8小时的总时间内(从第一次摄入扑热息痛剂量到最后一次摄入扑热息痛剂量)摄入过量的扑热息痛。“交错”摄入涉及在8小时至24小时的总时间内摄入过量的扑热息痛。“重复超治疗性摄入”是指摄入超过推荐日剂量超过24小时,“慢性”摄入包括交错或重复超治疗性摄入。“高风险过量”的定义是摄入剂量大于500mg /kg或30g(以较小者为准),或者在Rumack-Matthew nomogram line上,4 h时血清或血浆扑热息痛浓度大于300mg /L(1985µmol/L)。讨论:扑热息痛工作组建立的定义将构建即将进行的系统评价,确保每种摄入模式下的研究分类一致,以便对治疗和结果进行更清晰的比较。结论:我们鼓励研究人员一致地定义过量模式和肝毒性风险增加的患者,并将这些定义纳入出版物,以提高研究的可靠性和可比性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Paracetamol (acetaminophen) poisoning; consensus definitions of poisoning types and outcomes to be used in the clinical toxicology recommendations collaborative systematic review.

Introduction: Paracetamol (acetaminophen) poisoning is common, and many publications describe various outcomes and treatments. As internationally agreed definitions are non-existent to describe patterns of paracetamol overdose (acute, repeated supratherapeutic, chronic, or staggered), it is difficult to analyze outcomes between studies. The Clinical Toxicology Recommendations Collaborative was tasked to provide guidance on the management of paracetamol poisoning and formed the Paracetamol Workgroup. The Workgroup concluded that an agreed set of terms was needed to perform the systematic review and categorize the evidence.

Methods: A modified Delphi process was employed to establish uniform definitions to categorize various patterns of paracetamol overdose.

Results: Group consensus was reached for each one of the following standard definitions for each pattern of poisoning: acute, staggered, repeated supratherapeutic ingestions, and chronic for use in their upcoming systematic review. "Acute" ingestion represents an excessive amount of paracetamol ingested over a total time (from first paracetamol dose ingested to last paracetamol dose ingested) of less than 8 h. "Staggered" ingestion involves an excessive amount of paracetamol ingested over a total time period of between 8 h and 24 h. "Repeated supratherapeutic ingestion" describes ingestions exceeding the recommended daily dose for more than 24 h, and "chronic" ingestion includes both staggered or repeated supratherapeutic ingestions. "High-risk overdoses" are defined by either an ingested dose, that is greater than 500 mg/kg or 30 g (whichever is less), or an initial serum or plasma paracetamol concentration of greater than 300 mg/L (1,985 µmol/L) at 4 h on the Rumack-Matthew nomogram line.

Discussion: The definitions established by the Paracetamol Workgroup will structure the upcoming systematic review, ensuring consistent categorization of studies within each ingestion pattern to enable clearer comparisons of treatments and outcomes.

Conclusion: We encourage researchers to define overdose patterns and patients at increased risk of hepatotoxicity consistently and to include these definitions in publications to improve research reliability and comparability.

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来源期刊
Clinical Toxicology
Clinical Toxicology 医学-毒理学
CiteScore
5.70
自引率
12.10%
发文量
148
审稿时长
4-8 weeks
期刊介绍: clinical Toxicology publishes peer-reviewed scientific research and clinical advances in clinical toxicology. The journal reflects the professional concerns and best scientific judgment of its sponsors, the American Academy of Clinical Toxicology, the European Association of Poisons Centres and Clinical Toxicologists, the American Association of Poison Control Centers and the Asia Pacific Association of Medical Toxicology and, as such, is the leading international journal in the specialty.
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