Consensus statements on the approach to patients in a methanol poisoning outbreak

被引：25

作者：

Hassanian-Moghaddam, Hossein ^{[1
,2
]}

Zamani, Nasim ^{[1
,2
]}

Roberts, Darren M. ^{[3
,4
,5
]}

Brent, Jeffrey ^{[6
]}

McMartin, Kenneth ^{[7
]}

Aaron, Cynthia ^{[8
,9
]}

Eddleston, Michael ^{[10
]}

Dargan, Paul I. ^{[11
,12
]}

Olson, Kent ^{[13
]}

Nelson, Lewis ^{[14
]}

Bhalla, Ashish ^{[15
]}

Hantson, Philippe ^{[16
,17
]}

Jacobsen, Dag ^{[18
]}

Megarbane, Bruno ^{[19
]}

Balali-Mood, Mahdi ^{[20
]}

Buckley, Nicholas A. ^{[21
]}

Zakharov, Sergey ^{[22
,23
]}

Paasma, Raido ^{[24
]}

Jarwani, Bhavesh ^{[25
]}

Mirafzal, Amirhossein ^{[26
]}

Salek, Tomas ^{[27
]}

Hovda, Knut Erik ^{[28
]}

机构：

[1] Shahid Beheshti Univ Med Sci, Social Determinants Hlth Res Ctr, Tehran, Iran

[2] Shahid Beheshti Univ Med Sci, Sch Med, Loghman Hakim Hosp, Dept Clin Toxicol, Tehran, Iran

[3] Univ NSW, St Vincents Hosp, Dept Clin Pharmacol & Toxicol, Sydney, NSW, Australia

[4] Univ NSW, St Vincents Hosp, Dept Renal Med, Sydney, NSW, Australia

[5] Sydney Childrens Hosp, NSW Poisons Informat Ctr, Sydney, NSW, Australia

[6] Univ Colorado, Sch Med, Aurora, CO USA

[7] Louisiana State Univ, Hlth Sci Ctr Shreveport, Dept Pharmacol Toxicol & Neurosci, Shreveport, LA 71105 USA

[8] Childrens Hosp Michigan, Michigan Reg Poison Control Ctr, Detroit, MI 48201 USA

[9] Wayne State Univ, Sch Med, Emergency Med, Detroit, MI USA

[10] Univ Edinburgh, Univ BHF Ctr Cardiovasc Sci, Dept Pharmacol Toxicol & Therapeut, Edinburgh, Midlothian, Scotland

[11] Guys & St Thomas NHS Fdn Trust, Dept Clin Toxicol, London, England

[12] Kings Coll London, Fac Life Sci & Med, London, England

[13] Univ Calif San Francisco, San Francisco Div, Calif Poison Control Syst, San Francisco, CA 94143 USA

[14] Rutgers New Jersey Med Sch, Dept Emergency Med, Newark, NJ USA

[15] Postgrad Inst Med Educ & Res, Chandigarh, India

[16] Catholic Univ Louvain, Clin Univ St Luc, Bruxelles Dept Intens Care, Brussels, Belgium

[17] Catholic Univ Louvain, Clin Univ St Luc, Bruxelles Louvain Ctr Toxicol & Appl Pharmacol, Brussels, Belgium

[18] Univ Oslo, Oslo Univ Hosp, Dept Acute Med, Oslo, Norway

[19] Paris Diderot Univ, Dept Med & Toxicol Crit Care, Lariboisiere Hosp, INSERM UMRS 1144, Paris, France

[20] Mashhad Univ Med Sci, Sch Med, Med Toxicol Res Ctr, Mashhad, Razavi Khorasan, Iran

[21] Univ Sydney, Dept Pharmacol, Sydney, NSW, Australia

[22] Charles Univ Prague, Dept Occupat Med, Fac Med 1, Prague 2, Czech Republic

[23] Gen Univ Hosp, Toxicol Informat Ctr, Prague 2, Czech Republic

[24] Parnu Cty Hosp, Dept Anesthesiol & ICU, Parnu, Estonia

[25] VSGH, Dept Emergency Med, Ahmadabad, Gujarat, India

[26] Kerman Univ Med Sci, Dept Emergency Med, Kerman, Iran

[27] Tomas Bata Hosp, Dept Clin Biochem & Pharmacol, Zlin, Czech Republic

[28] Oslo Univ Hosp, Dept Acute Med, Norwegian CBRNE Ctr Med, Oslo, Norway

来源：

CLINICAL TOXICOLOGY | 2019年 / 57卷 / 12期

关键词：

Methanol; poisoning; outbreak; treatment; strategy; ANTIDOTES; HEMODIALYSIS; INTERMITTENT; EPIDEMIOLOGY; DURATION;

D O I：

10.1080/15563650.2019.1636992

中图分类号：

R99 [毒物学（毒理学）];

学科分类号：

100405 ;

摘要：

Background: Methanol poisoning is an important cause of mortality and morbidity worldwide. Although it often occurs as smaller sporadic events, epidemic outbreaks are not uncommon due to the illicit manufacture and sale of alcoholic beverages. Objective: We aimed to define methanol poisoning outbreak (MPO), outline an approach to triaging an MPO, and define criteria for prioritizing antidotes, extracorporeal elimination treatments (i.e., dialysis), and indications for transferring patients in the context of an MPO. Methods: We convened a group of experts from across the world to explore geographical, socio-cultural and clinical considerations in the management of an MPO. The experts answered specific open-ended questions based on themes aligned to the goals of this project. This project used a modified Delphi process. The discussion continued until there was condensation of themes. Results: We defined MPO as a sudden increase in the number of cases of methanol poisoning during a short period of time above what is normally expected in the population in that specific geographic area. Prompt initiation of an antidote is necessary in MPOs. Scarce hemodialysis resources require triage to identify patients most likely to benefit from this treatment. The sickest patients should not be transferred unless the time for transfer is very short. Transporting extracorporeal treatment equipment and antidotes may be more efficient. Conclusion: We have developed consensus statements on the response to a methanol poisoning outbreak. These can be used in any country and will be most effective when they are discussed by health authorities and clinicians prior to an outbreak.

引用

页码：1129 / 1136

页数：8

共 31 条

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