Salbutamol in acute organophosphorus insecticide poisoning - a pilotdose-response phase II study

Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
Fazle Rabbi ChowdhuryM Eddleston

Abstract

Treatment of acute organophosphorus (OP) insecticide poisoning is difficult, with many patients dying despite best care. Pre-clinical studies have shown benefit from salbutamol, possibly due speeding alveolar fluid clearance or reducing bronchoconstriction. In this small pilot dose-response study, we aimed to explore whether addition of nebulized salbutamol to standard care might improve resuscitation. We performed a single-blind phase II study comparing the effect of two different doses of nebulized salbutamol versus saline placebo, in addition to standard treatment. Primary outcome was oxygen saturations over the first 60 min of resuscitation; secondary outcomes included heart rate, incidence of dysrhythmias, time to 'atropinization', atropine dose required, and mortality. Seventy-five patients were randomized to receive 5 mg (Salb5, n = 25) or 2.5mg (Salb2.5, n = 25) of salbutamol, or saline placebo (NoSalb, n = 25), by nebulizer. Oxygen saturations did not differ between groups over the first 60 min of resuscitation (median AUC NoSalb: 1376 [95% CI 1282 to 1470], Salb2.5: 1395 [1305 to 1486], Salb5: 1233 [1100 to 1367]; p = .9898). Heart rate was also similar across the three arms. Median time to full atropinization, and at...Continue Reading

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Citations

Sep 20, 2018·Annual Review of Pharmacology and Toxicology·Michael Eddleston
Jan 31, 2019·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Julia HerbertTimo Wille
Jul 18, 2019·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Indi TrehanUNKNOWN Global Emergency Medicine Literature Review (GEMLR) Group
Jun 1, 2021·Critical Care Clinics·Sakib AmanFazle Rabbi Chowdhury
Dec 21, 2021·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Ashok Kumar PannuNavneet Sharma

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