The Comparison of Reported Ingested Paracetamol Dose with Serum Blood Concentrations and Their Relationship with N-Acetylcysteine Administration: A Retrospective Study of 117 Patients
Introduction:We aimed to compare the patient reported ingested and blood paracetamol concentrations (BPC) and to investigate the indications for N-acetylcysteine (NAC) administration in referred patients.Methods:This is a retrospective study of acute paracetamol intoxications (API) at the tertiary p...
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| Main Authors: | , , , , , , |
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| Format: | Book |
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Galenos Yayinevi,
2023-08-01T00:00:00Z.
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| Summary: | Introduction:We aimed to compare the patient reported ingested and blood paracetamol concentrations (BPC) and to investigate the indications for N-acetylcysteine (NAC) administration in referred patients.Methods:This is a retrospective study of acute paracetamol intoxications (API) at the tertiary paediatric emergency department (ED) between June 2015-June 2019. We evaluated the demographics, cause of intoxications, reported doses (mg/kg), BPCs (8/4/12/16 and/or 24th hours). Indications of antidote usage and referral to ED were accepted as BPC >150 mg/kg.Results:Overall, we reviewed 117 cases of acute API. The mean age was 8.97 (±6.0) years, and 68.3% were female. The reported ingested of paracetamol (RIP) median dose was 2725 mg (mean 138±51.9 mg/kg). Adolescents had a significantly higher RIP than that of younger subjects (p<0.001). BPC was performed in 88.9% of the patients at the 4th, 8th, 12th, 16th and 24th hour in 11.1%, 9.4%, 3.5% and 3.5% of cases, respectively. Although, only 34/66 of the referred cases had a RIP dose >150 mg/kg, physicians at the first healthcare facility tended to administer activated charcoal (90.9%), gastric lavage (68%) and intravenous NAC (48%). The referring healthcare facility physicians-initiated NAC particularly for patients who reported ingesting >150 mg/kg (p=0.001).Conclusion:RIP doses should not be used to determine the need for NAC. The antidote should be used in centres where BPCs are not available or in a group of patients who cannot be transferred to a referral centre within the first eight hours. |
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| Item Description: | 2146-2399 2148-7332 10.4274/cayd.galenos.2022.59454 |