Trial reportLancet (London, England)2003
Multiple-dose activated charcoal for treatment of yellow oleander poisoning: a single-blind, randomised, placebo-controlled trial.
Trial report in Lancet (London, England), 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 3 syntheses or guidelines pooled it, 145 citations in OpenAlex.
- Positive single-center randomized trials and subsequent multicenter randomized trials in critically ill patients: a systematic review.Critical care (London, England) · 2023Pooled it
- First aid interventions by laypeople for acute oral poisoning.The Cochrane database of systematic reviews · 2018Pooled it
- Antidotes for acute cardenolide (cardiac glycoside) poisoning.The Cochrane database of systematic reviews · 2006Pooled it
- Fructose-1, 6-diphosphate (FDP) as a novel antidote for yellow oleander-induced cardiac toxicity: a randomized controlled double blind study.BMC emergency medicine · 2010Trial
- Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial.Lancet (London, England) · 2008Trial
- Compliance for single and multiple dose regimens of superactivated charcoal: a prospective study of patients in a clinical trial.Clinical toxicology (Philadelphia, Pa.) · 2007Trial
- Pharmacokinetics of digoxin cross-reacting substances in patients with acute yellow Oleander (Thevetia peruviana) poisoning, including the effect of activated charcoal.Therapeutic drug monitoring · 2006Trial
- Fatal Yellow Oleander Poisoning From a Weight-Loss Seed Product Requiring Venoarterial Extracorporeal Membrane Oxygenation.JACC. Case reports · 2026Article
- Antidote use for cardiac arrest or hemodynamic instability due to cardiac glycoside poisoning: A narrative review.Resuscitation plus · 2024Review
- Indian Society of Critical Care Medicine Position Statement: Approach to a Patient with Poisoning in the Emergency Room and Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Dietary bamboo charcoal powder ameliorates high-fat diet-induced hyperlipidemia by enhancing fecal lipid excretions in Sprague-Dawley rats.Frontiers in nutrition · 2024Article
- Effects of multiple doses of montmorillonite, alone and in combination with activated charcoal, on the toxicokinetics of a single dose of digoxin in rats.Iranian journal of basic medical sciences · 2023Article
- Acute oleander poisoning: A study of clinical profile from a tertiary care center in South India.Journal of family medicine and primary care · 2020Article
- Oleander and Datura Poisoning: An Update.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- The Use of Activated Charcoal to Treat Intoxications.Deutsches Arzteblatt international · 2019Review
- Single dose activated charcoal for gut decontamination: Application by medical non-professionals -a prospective study on availability and practicability.Toxicology reports · 2017Article
- Pharmacological treatment of cardiac glycoside poisoning.British journal of clinical pharmacology · 2016Review
- Eating seeds from the 'be still' tree, yet having lucky nut poisoning: a case of acute yellow oleander poisoning.BMJ case reports · 2014Article
- Applied clinical pharmacology and public health in rural Asia--preventing deaths from organophosphorus pesticide and yellow oleander poisoning.British journal of clinical pharmacology · 2013Review
- Cleistanthus collinus poisoning.Journal of emergencies, trauma, and shock · 2012Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDeliberate self-poisoning with yellow oleander seeds is common in Sri Lanka and is associated with severe cardiac toxicity and a mortality rate of about 10%. Specialised treatment with antidigoxin Fab fragments and temporary cardiac pacing is expensive and not widely available. Multiple-dose activated charcoal binds cardiac glycosides in the gut lumen and promotes their elimination. We aimed to assess the efficacy of multiple-dose activated charcoal in the treatment of patients with yellow-oleander poisoning.
methodsOn admission, participants received one dose of activated charcoal and were then randomly assigned either 50 g of activated charcoal every 6 h for 3 days or sterile water as placebo. A standard treatment protocol was used in all patients. We monitored cardiac rhythm and did 12-lead electocardiographs as needed. Death was the primary endpoint, and secondary endpoints were life-threatening cardiac arrhythmias, dose of atropine used, need for cardiac pacing, admission to intensive care, and number of days in hospital. Analysis was by intention to treat.
findings201 patients received multiple-dose activated charcoal and 200 placebo. There were fewer deaths in the treatment group (five [2.5%] vs 16 [8%]; percentage difference 5.5%; 95% CI 0.6-10.3; p=0.025), and we noted difference in favour of the treatment group for all secondary endpoints, apart from number of days in hospital. The drug was safe and well tolerated.
interpretationMultiple-dose activated charcoal is effective in reducing deaths and life-threatening cardiac arrhythmias after yellow oleander poisoning and should be considered in all patients. Use of activated charcoal could reduce the cost of treatment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.