Volume 371, Issue 9612, Pages (February 2008)

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Presentation transcript:

Volume 371, Issue 9612, Pages 579-587 (February 2008) Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial Michael Eddleston, Edmund Juszczak, MSc, Nick A Buckley, MD, Lalith Senarathna, MSc, Fahim Mohamed, BSc, Wasantha Dissanayake, MD, Ariyasena Hittarage, MD, Shifa Azher, MD, K Jeganathan, MD, Shaluka Jayamanne, MD, Prof MH Rezvi Sheriff, FRCP, Prof David A Warrell, FMedSci The Lancet Volume 371, Issue 9612, Pages 579-587 (February 2008) DOI: 10.1016/S0140-6736(08)60270-6 Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 1 Trial profile *The proportion of patients who did not receive their intervention is an estimate derived from a prospective study of compliance in 1649 participants.31 The Lancet 2008 371, 579-587DOI: (10.1016/S0140-6736(08)60270-6) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 2 Forest plot of mortality for multiple-dose activated charcoal versus no activated charcoal MDAC=multiple-dose activated charcoal. AC=activated charcoal. OP=organophosphorus. GCS=Glasgow comma score. *Test for trend. The Lancet 2008 371, 579-587DOI: (10.1016/S0140-6736(08)60270-6) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 3 Forest plot of mortality for single-dose activated charcoal versus no activated charcoal SDAC=single-dose activated charcoal. AC=activated charcoal. OP=organophosphorus. GCS=Glasgow comma score. *Test for trend. The Lancet 2008 371, 579-587DOI: (10.1016/S0140-6736(08)60270-6) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 4 Cumulative percentage—for days to death (A) and to first intubation (B) (A) For the purpose of survival analysis, the clock was started at randomisation and stopped either at death or discharge (assumed to be 35 days if discharged alive sooner than 35 days). (B) For the purpose of survival analysis, the clock was started either at randomisation or, in the case of those who were intubated at randomisation, when the patient was first extubated. The clock stopped either at the first postrandomisation intubation or at death or discharge (assumed to be 8 days if discharged without intubation after less than 8 days). MDAC=multiple-dose activated charcoal. AC=activated charcoal. SDAC=single-dose activated charcoal. The Lancet 2008 371, 579-587DOI: (10.1016/S0140-6736(08)60270-6) Copyright © 2008 Elsevier Ltd Terms and Conditions

Figure 5 Forest plot of effect of time to recruitment on mortality for multiple-dose or single-dose activated charcoal versus no activated charcoal, with detailed breakdown of less than 4 h AC=activated charcoal. The Lancet 2008 371, 579-587DOI: (10.1016/S0140-6736(08)60270-6) Copyright © 2008 Elsevier Ltd Terms and Conditions