Comparison of three methods of gut decontamination in tricyclic antidepressant overdose☆
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Cited by (46)
Fundaments of Toxicology—Approach to the Poisoned Patient
2020, Advances in Chronic Kidney DiseaseCitation Excerpt :The procedure is associated with diminishing recovery of ingested poison or pills with time after ingestion; lack of demonstrable clinical benefit in illness severity, recovery time, or outcome; and significant risk of aspiration and pneumonitis, laryngospasm, and perforation of the stomach or esophagus (with mediastinal emphysema).7 Although lavage has been advocated for some toxins (eg, paraquat) or drugs that slow gastrointestinal transit (eg, tricyclic antidepressants), there is no sufficient evidence of clinical benefit when compared with activated charcoal.8 The use of gastric lavage in poisoning is so rarely employed that expertise is lacking and kits are largely unavailable.
Analysis of Gastric Lavage Reported to a Statewide Poison Control System
2016, Journal of Emergency MedicineManagement of the comatose patient
2008, Handbook of Clinical NeurologyCitation Excerpt :These patients are at high risk of complications from respiratory failure, hemodynamic collapse, cardiac arrhythmias, and seizures. Activated charcoal (1 g/kg), with or without gastric lavage, may effectively reduce drug absorption when promptly administered (Bosse et al., 1995). Mortality is closely related to cardiac toxicity caused by delayed depolarization, conduction abnormalities, and decreased myocardial contractility due to inhibition of voltage-gated sodium channels.
The Approach to the Patient with an Unknown Overdose
2007, Emergency Medicine Clinics of North AmericaCitation Excerpt :Gastric lavage is no longer indicated for most ingestions [3]. Gastric lavage may be considered if a patient has ingested a potentially life-threatening amount of a toxin and presents within 1 hour of ingestion [3,74–79]. Even in this scenario, however, there is no clear evidence that its use improves clinical outcome.
Toxicology in the critically ill patient
2003, Clinics in Chest Medicine
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Presented in part at the Southern Medical Association Annual Meeting in San Antonio, TX, November 1992.