Extracorporeal treatment for tricyclic antidepressant poisoning: Recommendations from the EXTRIP workgroup

Christopher Yates, Tais Galvao, Kevin M. Sowinski, Karine Mardini, Tudor Botnaru, Sophie Gosselin, Robert S. Hoffman, Thomas D. Nolin, Valéry Lavergne, Marc Ghannoum, Kurt Anseeuw, Ashish Bhalla, Emmanuel A. Burdmann, Paul I. Dargan, Brian Decker, David S. Goldfarb, Lotte C. Hoegberg, David Juurlink, Martin Laliberté, Jan T. KielsteinYi Li, Kathleen D. Liu, Robert MacLaren, Robert Mactier, Bruno Mégarbane, James B. Mowry, Véronique Phan, Darren M. Roberts, Timothy J. Wiegand, James F. Winchester

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed in person at a meeting. A second vote determined the final recommendations. Seventy-seven articles met inclusion criteria. Only case reports, case series, and one poor-quality observational study were identified yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers that poisoned patients with TCAs are not likely to have a clinical benefit from extracorporeal removal and recommends it NOT to be used in TCA poisoning.

Original languageEnglish (US)
Pages (from-to)381-389
Number of pages9
JournalSeminars in Dialysis
Volume27
Issue number4
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Tricyclic Antidepressive Agents
Poisoning
Politics
Therapeutics
Poisons
Observational Studies

ASJC Scopus subject areas

  • Nephrology

Cite this

Yates, C., Galvao, T., Sowinski, K. M., Mardini, K., Botnaru, T., Gosselin, S., ... Winchester, J. F. (2014). Extracorporeal treatment for tricyclic antidepressant poisoning: Recommendations from the EXTRIP workgroup. Seminars in Dialysis, 27(4), 381-389. https://doi.org/10.1111/sdi.12227

Extracorporeal treatment for tricyclic antidepressant poisoning : Recommendations from the EXTRIP workgroup. / Yates, Christopher; Galvao, Tais; Sowinski, Kevin M.; Mardini, Karine; Botnaru, Tudor; Gosselin, Sophie; Hoffman, Robert S.; Nolin, Thomas D.; Lavergne, Valéry; Ghannoum, Marc; Anseeuw, Kurt; Bhalla, Ashish; Burdmann, Emmanuel A.; Dargan, Paul I.; Decker, Brian; Goldfarb, David S.; Hoegberg, Lotte C.; Juurlink, David; Laliberté, Martin; Kielstein, Jan T.; Li, Yi; Liu, Kathleen D.; MacLaren, Robert; Mactier, Robert; Mégarbane, Bruno; Mowry, James B.; Phan, Véronique; Roberts, Darren M.; Wiegand, Timothy J.; Winchester, James F.

In: Seminars in Dialysis, Vol. 27, No. 4, 2014, p. 381-389.

Research output: Contribution to journalArticle

Yates, C, Galvao, T, Sowinski, KM, Mardini, K, Botnaru, T, Gosselin, S, Hoffman, RS, Nolin, TD, Lavergne, V, Ghannoum, M, Anseeuw, K, Bhalla, A, Burdmann, EA, Dargan, PI, Decker, B, Goldfarb, DS, Hoegberg, LC, Juurlink, D, Laliberté, M, Kielstein, JT, Li, Y, Liu, KD, MacLaren, R, Mactier, R, Mégarbane, B, Mowry, JB, Phan, V, Roberts, DM, Wiegand, TJ & Winchester, JF 2014, 'Extracorporeal treatment for tricyclic antidepressant poisoning: Recommendations from the EXTRIP workgroup', Seminars in Dialysis, vol. 27, no. 4, pp. 381-389. https://doi.org/10.1111/sdi.12227
Yates, Christopher ; Galvao, Tais ; Sowinski, Kevin M. ; Mardini, Karine ; Botnaru, Tudor ; Gosselin, Sophie ; Hoffman, Robert S. ; Nolin, Thomas D. ; Lavergne, Valéry ; Ghannoum, Marc ; Anseeuw, Kurt ; Bhalla, Ashish ; Burdmann, Emmanuel A. ; Dargan, Paul I. ; Decker, Brian ; Goldfarb, David S. ; Hoegberg, Lotte C. ; Juurlink, David ; Laliberté, Martin ; Kielstein, Jan T. ; Li, Yi ; Liu, Kathleen D. ; MacLaren, Robert ; Mactier, Robert ; Mégarbane, Bruno ; Mowry, James B. ; Phan, Véronique ; Roberts, Darren M. ; Wiegand, Timothy J. ; Winchester, James F. / Extracorporeal treatment for tricyclic antidepressant poisoning : Recommendations from the EXTRIP workgroup. In: Seminars in Dialysis. 2014 ; Vol. 27, No. 4. pp. 381-389.
@article{0e26c4b6df0e46e68ad3ffc264a047cd,
title = "Extracorporeal treatment for tricyclic antidepressant poisoning: Recommendations from the EXTRIP workgroup",
abstract = "The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed in person at a meeting. A second vote determined the final recommendations. Seventy-seven articles met inclusion criteria. Only case reports, case series, and one poor-quality observational study were identified yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers that poisoned patients with TCAs are not likely to have a clinical benefit from extracorporeal removal and recommends it NOT to be used in TCA poisoning.",
author = "Christopher Yates and Tais Galvao and Sowinski, {Kevin M.} and Karine Mardini and Tudor Botnaru and Sophie Gosselin and Hoffman, {Robert S.} and Nolin, {Thomas D.} and Val{\'e}ry Lavergne and Marc Ghannoum and Kurt Anseeuw and Ashish Bhalla and Burdmann, {Emmanuel A.} and Dargan, {Paul I.} and Brian Decker and Goldfarb, {David S.} and Hoegberg, {Lotte C.} and David Juurlink and Martin Lalibert{\'e} and Kielstein, {Jan T.} and Yi Li and Liu, {Kathleen D.} and Robert MacLaren and Robert Mactier and Bruno M{\'e}garbane and Mowry, {James B.} and V{\'e}ronique Phan and Roberts, {Darren M.} and Wiegand, {Timothy J.} and Winchester, {James F.}",
year = "2014",
doi = "10.1111/sdi.12227",
language = "English (US)",
volume = "27",
pages = "381--389",
journal = "Seminars in Dialysis",
issn = "0894-0959",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Extracorporeal treatment for tricyclic antidepressant poisoning

T2 - Recommendations from the EXTRIP workgroup

AU - Yates, Christopher

AU - Galvao, Tais

AU - Sowinski, Kevin M.

AU - Mardini, Karine

AU - Botnaru, Tudor

AU - Gosselin, Sophie

AU - Hoffman, Robert S.

AU - Nolin, Thomas D.

AU - Lavergne, Valéry

AU - Ghannoum, Marc

AU - Anseeuw, Kurt

AU - Bhalla, Ashish

AU - Burdmann, Emmanuel A.

AU - Dargan, Paul I.

AU - Decker, Brian

AU - Goldfarb, David S.

AU - Hoegberg, Lotte C.

AU - Juurlink, David

AU - Laliberté, Martin

AU - Kielstein, Jan T.

AU - Li, Yi

AU - Liu, Kathleen D.

AU - MacLaren, Robert

AU - Mactier, Robert

AU - Mégarbane, Bruno

AU - Mowry, James B.

AU - Phan, Véronique

AU - Roberts, Darren M.

AU - Wiegand, Timothy J.

AU - Winchester, James F.

PY - 2014

Y1 - 2014

N2 - The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed in person at a meeting. A second vote determined the final recommendations. Seventy-seven articles met inclusion criteria. Only case reports, case series, and one poor-quality observational study were identified yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers that poisoned patients with TCAs are not likely to have a clinical benefit from extracorporeal removal and recommends it NOT to be used in TCA poisoning.

AB - The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND/UCLA Appropriateness Method to quantify disagreement. Blinded votes were compiled, returned, and discussed in person at a meeting. A second vote determined the final recommendations. Seventy-seven articles met inclusion criteria. Only case reports, case series, and one poor-quality observational study were identified yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers that poisoned patients with TCAs are not likely to have a clinical benefit from extracorporeal removal and recommends it NOT to be used in TCA poisoning.

UR - http://www.scopus.com/inward/record.url?scp=84904036657&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84904036657&partnerID=8YFLogxK

U2 - 10.1111/sdi.12227

DO - 10.1111/sdi.12227

M3 - Article

C2 - 24712820

AN - SCOPUS:84904036657

VL - 27

SP - 381

EP - 389

JO - Seminars in Dialysis

JF - Seminars in Dialysis

SN - 0894-0959

IS - 4

ER -