title: An exploratory study; the therapeutic effects of premixed activated charcoal-sorbitol administration in patients poisoned with organophosphate pesticide.
abstract: OBJECTIVE
  The effects of activated charcoal (AC) mixed with cathartics for gastric decontamination in the management of organophosphate (OP) poisoning remain unknown due to limited clinical evidence. This exploratory study assessed the effectiveness of premixed AC-sorbitol as a treatment for OP poisoning.
  
  
  METHODS
  This retrospective observational case study included patients who either did not receive AC-sorbitol or received a single dose of AC-sorbitol within 24 h after OP ingestion. The patients were divided into three groups: no AC-sorbitol treatment, patients who received AC-sorbitol within 1 h of OP ingestion, and patients who received AC-sorbitol more than 1 h after OP ingestion. Mortality, the development of respiratory failure, and the duration of mechanical ventilation were used as outcome measurements for effectiveness, whereas aspiration pneumonia and electrolyte imbalance were employed as safety measurements.
  
  
  RESULTS
  Among 262 patients with OP poisoning, 198 were included. Of these, 133 patients did not receive AC-sorbitol, whereas 14 and 51 patients received AC-sorbitol within 1 h or more than 1 h after ingestion, respectively. The time from ingestion to hospital arrival and time from ingestion to administration of atropine and pralidoxime differed among the groups, whereas other characteristics, including age, amount ingested, and type of ingested OP, were similar among the groups. Univariate and multivariate analysis demonstrated that the administration of AC-sorbitol was not associated with outcome measures for effectiveness and did not significantly increase either aspiration pneumonia or electrolyte imbalances during hospitalization.
  
  
  CONCLUSIONS
  The administration of AC-sorbitol exerted neither beneficial nor harmful effects on the outcomes of OP-poisoned patients regardless of the time from OP ingestion to administration, compared with those of patients who did not receive AC-sorbitol. However, this study enrolled a small number of patients who received AC-sorbitol; further qualified trials with a sufficient number of patients are therefore needed.
authors.affiliation: Department of Emergency Medicine, Chonnam National University Medical School , Gwangju , South Korea.
authors.forename: Jeongmi
authors.initials: J
authors.lastname: Moon
authors.forename: Byeongjo
authors.initials: B
authors.lastname: Chun
authors.forename: Kyounghwan
authors.initials: K
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D000931:Antidotes / Q000008:administration & dosage / Q000627:therapeutic use*; D001285:Atropine / Q000627:therapeutic use; D002400:Cathartics / Q000008:administration & dosage / Q000627:therapeutic use*; D002606:Charcoal / Q000008:administration & dosage / Q000627:therapeutic use*; D002801:Cholinesterase Reactivators / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D062025:Organophosphate Poisoning / Q000188:drug therapy*; D010575:Pesticides / Q000506:poisoning*; D011220:Pralidoxime Compounds / Q000627:therapeutic use; D012189:Retrospective Studies; D013012:Sorbitol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000931:Antidotes; D002400:Cathartics; D002801:Cholinesterase Reactivators; D004338:Drug Combinations; D018727:Muscarinic Antagonists; D010575:Pesticides; D011220:Pralidoxime Compounds; D002606:Charcoal; D013012:Sorbitol; D001285:Atropine; C028797:pralidoxime
keywords: Activated charcoal; Organophosphate; Sorbitol