Evidence map›Paper›PMID 34845647›Full record

ArticleJournal of medical toxicology : official journal of the American College of Medical Toxicology2022

Activated Charcoal and Bicarbonate for Aspirin Toxicity: a Retrospective Series.

K Z Isoardi, C Henry, K Harris, G K Isbister

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of medical toxicology : official journal of the American College of Medical Toxicology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.2field-weighted citation impact, top 8% of its field
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

5 citing papers in PubMed, 16 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Reflections on Aspirin Toxicity: Interpreting Effects of Sodium Bicarbonate and Activated Charcoal.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2022
    Article
  5. Reply to "Reflections on Aspirin Toxicity: Interpreting Effects of Sodium Bicarbonate and Activated Charcoal".Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 1 country.

K Z IsoardiClinical Toxicology Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia. katherine.isoardi@health.qld.gov.au.
C HenryFaculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
K HarrisClinical Toxicology Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia.
G K IsbisterClinical Toxicology Research Group, University of Newcastle, Newcastle, NSW, Australia.
Calvary Mater Newcastle Hospital · AUPrincess Alexandra Hospital · AUThe University of Queensland · AUUniversity of Newcastle Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAspirin overdose causes acid-base disturbances and organ dysfunction. Management is guided by research reported over 50 years ago when chronic aspirin toxicity was common and accounted for significant morbidity. We investigate our experience of aspirin overdose and the effectiveness of charcoal and bicarbonate administration over 20 years.

methodsThis is a retrospective series of acute aspirin overdose from two toxicology units from January 2000 to September 2019. Acute aspirin ingestions > 3000 mg were identified in each unit's database. Excluded were cases of chronic exposure, hospital presentation > 24 hours after ingestion, and cases without a salicylate concentration. Included in our analysis was demographic data, clinical effects, investigations, complications, and treatment.

resultsThere were 132 presentations in 108 patients (79 females (73%)). The median age was 28 years (range: 13-93 years). The median dose ingested was 7750 mg (IQR: 6000-14,400 mg). There were 44 aspirin-only ingestions. Mild toxicity (nausea, vomiting, tinnitus or hyperventilation) occurred in 22 with a median dose of 160 mg/kg. Moderate toxicity (acid-base disturbance, confusion) occurred in 16 with a median ingested dose of 297 mg/kg. There were no cases of severe toxicity (coma or seizures) due to aspirin alone. The median peak salicylate concentration was 276 mg/L (IQR: 175-400 mg/L, range: 14-814 mg/L). There was a moderate association between dose ingested and peak concentration (Pearson r = 0.58; 95% CI 0.45-0.68). Activated charcoal was administered in 36 (27%) cases, which decreased the median peak salicylate concentration (34.2 to 24.8 mg/L/g (difference: 9.4, 95% CI: 1.0-13.1)). Bicarbonate was administered in 34 (26%) presentations, decreasing the median apparent elimination half-life from 13.4 to 9.3 h (difference: 4.2 h, 95% CI: 1.0-6.5 h).

conclusionsAcute aspirin overdose caused only mild to moderate effects in this series. Early administration of activated charcoal decreased absorption and use of bicarbonate enhanced elimination.

Indexed as

BicarbonatesCharcoalAdultAspirinFemaleHumansRetrospective StudiesSalicylatesAspirinBicarbonatesCharcoalSalicylatesActivated charcoalAspirinBicarbonateOverdosePoisoningSalicylate

Identifiers

PMID34845647
PMCPMC8758842
OpenAlexW3216817605

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.