苏格兰和纽卡斯尔止吐方案(SNAP):针对扑热息痛过量的12小时乙酰半胱氨酸方案可在不影响所有年龄组肝脏保护的情况下减少类过敏反应:一项次要分析。

IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE
Christopher Humphries, Janice Pettie, Bridget Agboola, Thomas M Caparrotta, Robert W Hunter, Emma Morrison, Euan A Sandilands, David J Webb, Michael Eddleston, James Dear
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引用次数: 0

摘要

背景:12小时苏格兰和纽卡斯尔止吐方案(SNAP)乙酰半胱氨酸方案治疗与成人患者住院时间缩短和类过敏反应减少有关,该方案现在被几个英国组织推荐并广泛使用。采用的一个潜在障碍是担心方案的性能可能随着患者年龄的变化而变化。有趣的是,这导致在儿科环境中采用较慢。方法:对2013年9月28日至2017年9月27日期间在英国爱丁堡皇家医院接受乙酰半胱氨酸治疗的对乙酰氨基酚过量患者的2212例数据进行二次分析。患者按10岁年龄分组,以便比较不同年龄的治疗方案的效果。比较各组的类过敏反应发生率、乙酰半胱氨酸输注引起的住院时间以及生化指标评估的肝损伤严重程度。结果:接受SNAP治疗的所有年龄组患者的类过敏反应均有统计学意义的显著降低。两组急性肝损伤程度生化指标无显著差异。结论:该二次分析提供的数据支持无论患者年龄如何使用SNAP,并向临床医生保证,没有证据表明先前未被认识到的方案性能变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Scottish and Newcastle Antiemetic Protocol (SNAP) 12-hour acetylcysteine regimen for paracetamol overdose reduces anaphylactoid reactions without compromising hepatic protection in all age groups: a secondary analysis.

Background: Treatment with the 12-hour Scottish and Newcastle Antiemetic Protocol (SNAP) acetylcysteine regimen is associated with decreased length of stay and fewer anaphylactoid reactions in adult patients, and the protocol is now recommended by several UK organisations and used widely. One potential barrier to adoption is concern regarding the potential for variation in protocol performance with patient age. Anecdotally, this has led to slower adoption in paediatric settings.

Methods: Secondary analysis of data from 2212 patients at the Royal Infirmary of Edinburgh, UK, treated with acetylcysteine for paracetamol overdose between 28 September 2013 and 27 September 2017. Patients were grouped into 10-year age ranges to allow comparison of treatment regimen performance across ages. Groups were compared for their rates of anaphylactoid reactions, duration of admission attributable to acetylcysteine infusion and severity of liver injury assessed by biochemical markers.

Results: Patients in all age groups treated with SNAP experienced statistically significant reductions in anaphylactoid reactions. There were no significant differences in the severity of acute liver injury as assessed by biochemical results.

Conclusion: This secondary analysis provides data to support the use of SNAP regardless of patient age and reassure clinicians that there is no evidence of previously unrecognised variation in protocol performance.

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来源期刊
Emergency Medicine Journal
Emergency Medicine Journal 医学-急救医学
CiteScore
4.40
自引率
6.50%
发文量
262
审稿时长
3-8 weeks
期刊介绍: The Emergency Medicine Journal is a leading international journal reporting developments and advances in emergency medicine and acute care. It has relevance to all specialties involved in the management of emergencies in the hospital and prehospital environment. Each issue contains editorials, reviews, original research, evidence based reviews, letters and more.
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