Trial reportLancet (London, England)2008
Multiple-dose activated charcoal in acute self-poisoning: a randomised controlled trial.
Trial report in Lancet (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
56 citing papers in PubMed, 4 syntheses or guidelines pooled it, 233 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
- Interventions for paracetamol (acetaminophen) overdose.The Cochrane database of systematic reviews · 2018Pooled it
- Organophosphorus poisoning (acute).BMJ clinical evidence · 2011Pooled it
- Is oxygen required before atropine administration in organophosphorus or carbamate pesticide poisoning? - A cohort study.Clinical toxicology (Philadelphia, Pa.) · 2014Trial
- Scottish and Newcastle antiemetic pre-treatment for paracetamol poisoning study (SNAP).BMC pharmacology & toxicology · 2013Trial
- 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
- Pralidoxime in acute organophosphorus insecticide poisoning--a randomised controlled trial.PLoS medicine · 2009Trial
- Predicting outcome using butyrylcholinesterase activity in organophosphorus pesticide self-poisoning.QJM : monthly journal of the Association of Physicians · 2008Trial
- Urine Dithionite-guided Hemoperfusion in Acute Paraquat Poisoning: A Retrospective Observational Study from South India.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2026Article
- Caffeine and the Young Heart: A Systematic Review of Arrhythmogenic Risks in Children and Adolescents.Pediatric cardiology · 2026Review
- When herbal supplements cause heart problems: Clinical case report and forensic toxicological analysis.Toxicology reports · 2026Article
- Bio-friendly multi-stimuli responsive α-CD polymer-gated mesoporous carbon nanoherbicides for enhanced paraquat delivery.Journal of advanced research · 2025Article
- Article
- Incidence of hypernatremia in dogs treated with multi-dose activated charcoal for acute toxicant ingestion: multi-center retrospective study (2018-2023).Frontiers in veterinary science · 2025Article
- Predicting mortality in paraquat poisoning through clinical findings, with a focus on pulmonary and cardiovascular system disorders.Journal of pharmaceutical policy and practice · 2023Article
- Lipid Emulsion to Treat Acute Poisonings: Mechanisms of Action, Indications, and Controversies.Pharmaceutics · 2023Review
- Clinical characteristics, treatment and outcomes of acute propanil poisoning in a 7-year retrospective cohort study.Toxicology reports · 2022Article
- Case fatality of agricultural pesticides after self-poisoning in Sri Lanka: a prospective cohort study.The Lancet. Global health · 2021Observational
- The Individualized Management Approach for Acute Poisoning.Advances in pharmacological and pharmaceutical sciences · 2021Review
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundThe case-fatality for intentional self-poisoning in the rural developing world is 10-50-fold higher than that in industrialised countries, mostly because of the use of highly toxic pesticides and plants. We therefore aimed to assess whether routine treatment with multiple-dose activated charcoal, to interrupt enterovascular or enterohepatic circulations, offers benefit compared with no charcoal in such an environment.
methodsWe did an open-label, parallel group, randomised, controlled trial of six 50 g doses of activated charcoal at 4-h intervals versus no charcoal versus one 50 g dose of activated charcoal in three Sri Lankan hospitals. 4632 patients were randomised to receive no charcoal (n=1554), one dose of charcoal (n=1545), or six doses of charcoal (n=1533); outcomes were available for 4629 patients. 2338 (51%) individuals had ingested pesticides, whereas 1647 (36%) had ingested yellow oleander (Thevetia peruviana) seeds. Mortality was the primary outcome measure. Analysis was by intention to treat. The trial is registered with controlled-trials.com as ISRCTN02920054.
findingsMortality did not differ between the groups. 97 (6.3%) of 1531 participants in the multiple-dose group died, compared with 105 (6.8%) of 1554 in the no charcoal group (adjusted odds ratio 0.96, 95% CI 0.70-1.33). No differences were noted for patients who took particular poisons, were severely ill on admission, or who presented early.
interpretationWe cannot recommend the routine use of multiple-dose activated charcoal in rural Asia Pacific; although further studies of early charcoal administration might be useful, effective affordable treatments are urgently needed.
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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.