Evidence map›Paper›PMID 33226502›Full record

ReviewAnnals of intensive care2020

Management of pharmaceutical and recreational drug poisoning.

Bruno Mégarbane, Mathieu Oberlin, Jean-Claude Alvarez, Frederic Balen, Sébastien Beaune, Régis Bédry, Anthony Chauvin, Isabelle Claudet, Vincent Danel, Guillaume Debaty and 20 more

Abstract readReview
In one paragraph

Review in Annals of intensive care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed.

  1. Effect of Activated Charcoal on Mavacamten Pharmacokinetics in Healthy Participants.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024
    Trial
  2. Toxidromes.Nature reviews. Disease primers · 2026
    Review
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Article
  10. Article
  11. 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 · 2024
    Article
  12. Article
  13. Article
  14. Progress on the Electrochemical Sensing of Illicit Drugs.Advances in biochemical engineering/biotechnology · 2024
    Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Bruno MégarbaneDepartment of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, AP-HP, INSERM MURS-1144, University of Paris, 2 Rue Ambroise Paré, Paris, 75010, France. bruno.megarbane@lrb.aphp.fr.ORCID http://orcid.org/0000-0002-2522-2764
Mathieu OberlinEmergency Department, HuManiS Laboratory (EA7308), University Hospital, Strasbourg, France.
Jean-Claude AlvarezDepartment of Pharmacology and Toxicology, Inserm U-1173, FHU Sepsis, Raymond Poincaré Hospital, AP-HP, Paris-Saclay University, Garches, France.
Frederic BalenEmergency Department, Toulouse University Hospital, Toulouse, France.
Sébastien BeauneDepartment of Emergency Medicine, Ambroise Paré Hospital, AP-HP, INSERM UMRS-1144, Paris-Saclay University, Boulogne-Billancourt, France.
Régis BédryHospital Secure Unit, Pellegrin University Hospital, Bordeaux, France.
Anthony ChauvinEmergency Department, Hôpital Lariboisière, AP-HP, Paris, France.
Isabelle ClaudetPediatric Emergency Department Children's Hospital CHU Toulouse, Toulouse, France.
Vincent DanelDepartment of Emergency Medicine, University Hospital of Grenoble, Grenoble, France.
Guillaume Debaty5525, University Grenoble Alps/CNRS/CHU de Grenoble Alpes/TIMC-IMAG UMR, Grenoble, France.
Arnaud DelahayeIntensive Care Unit, Rodez Hospital, Rodez, France.
Nicolas DeyeDepartment of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, AP-HP, INSERM U942, University of Paris, Paris, France.
Jean-Michel GaulierLaboratory of Toxicology, EA 4483 - IMPECS - IMPact de L'Environnement Chimique Sur La Santé Humaine, University of Lille, Lille, France.
Francis GrossenbacherEmergency Department, Reims University Hospital, Reims, France.
Philippe HantsonIntensive Care Department, Cliniques Universitaires St-Luc, Brussels, Belgium.
Frédéric JacobsPolyvalent Intensive Care Unit, Antoine Béclère Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Sud University, Clamart, France.
Karim JaffalDepartment of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, AP-HP, INSERM MURS-1144, University of Paris, 2 Rue Ambroise Paré, Paris, 75010, France.
Magali LabadiePoison Control Centre of Bordeaux, University Hospital of Bordeaux, Bordeaux, France.
Laurence LabatLaboratory of Toxicology, Federation of Toxicology APHP, Lariboisière Hospital, INSERM UMRS-1144, University of Paris, Paris, France.
Jérôme LangrandPoison Control Center of Paris, Federation of Toxicology, Fernand-Widal-Lariboisière Hospital, AP-HP, INSERM UMRS-1144, University of Paris, Paris, France.
Frédéric LapostolleSAMU 93-UF Recherche-Enseignement-Qualité, Inserm, U942, Avicenne Hospital, AP-HP, Paris-13 University, Bobigny, France.
Philippe Le ConteDepartment of Emergency Medicine, University Hospital of Nantes, Nantes, France.
Maxime MaignanEmergency Department, Grenoble University Hospital, INSERM U1042, Grenoble Alpes University, Grenoble, France.
Patrick NissePoison Control Centre, University Hospital of Lille, Lille, France.
Philippe SauderIntensive Care Unit, University Hospital of Strasbourg, Strasbourg, France.
Christine TournoudPoison Control Centre, University Hospital of Nancy, Nancy, France.
Dominique VodovarPoison Control Center of Paris, Federation of Toxicology, Fernand-Widal-Lariboisière Hospital, AP-HP, INSERM UMRS-1144, University of Paris, Paris, France.
Sebastian VoicuDepartment of Medical and Toxicological Critical Care, Federation of Toxicology, Lariboisière Hospital, AP-HP, INSERM MURS-1144, University of Paris, 2 Rue Ambroise Paré, Paris, 75010, France.
Pierre-Géraud ClaretDepartment of Anesthesia Resuscitation Pain Emergency Medicine, Nîmes University Hospital, Nîmes, France.
Charles CerfIntensive Care Unit, Foch Hospital, Suresnes, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPoisoning is one of the leading causes of admission to the emergency department and intensive care unit. A large number of epidemiological changes have occurred over the last years such as the exponential growth of new synthetic psychoactive substances. Major progress has also been made in analytical screening and assays, enabling the clinicians to rapidly obtain a definite diagnosis.

methodsA committee composed of 30 experts from five scientific societies, the Société de Réanimation de Langue Française (SRLF), the Société Française de Médecine d'Urgence (SFMU), the Société de Toxicologie Clinique (STC), the Société Française de Toxicologie Analytique (SFTA) and the Groupe Francophone de Réanimation et d'Urgences Pédiatriques (GFRUP) evaluated eight fields: (1) severity assessment and initial triage; (2) diagnostic approach and role of toxicological analyses; (3) supportive care; (4) decontamination; (5) elimination enhancement; (6) place of antidotes; (7) specificities related to recreational drug poisoning; and (8) characteristics of cardiotoxicant poisoning. Population, Intervention, Comparison, and Outcome (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Analysis of the literature and formulation of recommendations were then conducted according to the GRADE

resultsThe SRLF-SFMU guideline panel provided 41 statements concerning the management of pharmaceutical and recreational drug poisoning. Ethanol and chemical poisoning were excluded from the scope of these recommendations. After two rounds of discussion and various amendments, a strong consensus was reached for all recommendations. Six of these recommendations had a high level of evidence (GRADE 1±) and six had a low level of evidence (GRADE 2±). Twenty-nine recommendations were in the form of expert opinion recommendations due to the low evidences in the literature.

conclusionsThe experts reached a substantial consensus for several strong recommendations for optimal management of pharmaceutical and recreational drug poisoning, mainly regarding the conditions and effectiveness of naloxone and N-acetylcystein as antidotes to treat opioid and acetaminophen poisoning, respectively.

Indexed as

AntidoteGuidelinesIntoxicationPharmaceutical drugPoisoningRecreational drug

Identifiers

PMID33226502
PMCPMC7683636

What OpenQuestion holds

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Registered trials

None linked

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.