Clinical trial NCT05148611: Application Registration Study of ILE in Patients With Acute Poisoning
Official title: Application Registration Study of ILE in Patients With Acute Poisoning
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Acute Poisoning
Keywords: Acute poisoning
intravenous lipid emulsion
Lead sponsor: Peking Union Medical College Hospital
Sponsor class: OTHER
Collaborators: name: The Affiliated Hospital of Qingdao University
name: The First Affiliated Hospital, Guangzhou University of Traditional Chinese Medicine
name: People's Hospital of Deyang City
name: Binzhou Medical University
name: People's Hospital of Zhengzhou University
First posted: 2021-12-08
Enrollment: 500
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: According to the indications of ILE in the treatment of poisoning in clinical toxicology, the research objects are divided into the following categories:

1. Calcium channel blocker poisoning
2. Beta blocker drug poisoning
3. Tricyclic antidepressant poisoning
4. Organophosphorus (fat-soluble) pesticide poisoning, such as: chlorpyrifos, profenofos, diazinon, fenthion, phosphaphos, quinalphos, butylpyrimidin, thiazophos, omethoate, dimethoate Methionine, triazophos, thiomethionine, ethion, sulfoxiphos, imiphos, fosfoxcarb, pyrifoxaphos, hydrocarbophos, phorate, methyl parathion, parasulfur Phosphorus, dichlorvos, pyridoxine, etc.
5. Local anesthetic poisoning
6. Poisoning by other fat-soluble substances

Brief summary: In this study, the investigators aimed to study the effect of ILE in the treatment of acute fat-soluble substance poisoning,to further clarify the relevant mechanism of ILE in the treatment of fat-soluble drug poisoning,to standardize the relevant procedures of ILE detoxification treatment and further explore the adverse reactions and coping strategies of ILE treatment.

Detailed description: Fat-soluble drugs refer to drugs that are insoluble in water but soluble in fats and organic solvents such as carbon tetrachloride, glycerol, oils and other organic solvents. They can fuse with the phospholipid bilayer of cell membranes, are easily absorbed, and are easier to pass compared to water-soluble drugs. It is metabolized by the liver, and the metabolites are excreted by the kidneys, so it has a high clinical use rate. However, in recent years, due to the improper use of fat-soluble drugs by patients, fat-soluble benzodiazepines sedative and hypnotic drugs, fat-soluble calcium channel blockers and β-blocker drugs, fat-soluble tricyclic drugs have often occurred. Poisoning such as antidepressants poses a serious threat to the lives of patients.In addition, organophosphorus pesticides (fat-soluble) have a high usage rate in China. Severe organophosphorus poisoning can cause multiple organ damages, and delays in treatment can cause disability or even death. Clinical treatment is mainly based on routine gastric lavage and oxygen inhalation. Treatment is the mainstay, combined with medical drugs, hemodialysis, hemoperfusion, etc., and has achieved certain curative effects, but the mortality rate is still high, so it is of great significance to explore safer and more effective treatment methods.Intravenous lipid emulsion (ILE) was originally used to treat overdose of local anesthetics such as bupivacaine, and later also used to treat a variety of other lipophilic drug poisonings. The research on the treatment of ILE is still in the preliminary stage and relatively limited. A systematic review of fat emulsions for the treatment of acute poisoning found that the overall quality of the studies supporting this treatment is low or very low, but the included case reports indicate that fat emulsions are effective against verapamil, beta blockers, and certain Tricyclic antidepressants, bupivacaine, chlorpromazine, and certain antiarrhythmic drugs (eg, flecainide) poisoned patients have certain benefits. ILE may help treat patients who are hemodynamically unstable due to poisoning by these drugs.In view of the fact that the research on the treatment of ILE still needs to be further improved and related adverse reactions need to be further explored related countermeasures, the investigators plan to launch a registration research program related to the application of fat emulsion.

Eligibility criteria: Inclusion Criteria:

1. Diagnosed as acute fat-soluble drug and organophosphorus (fat-soluble) pesticide poisoning;
2. Conventional treatment is ineffective, especially for patients with circulatory failure, such as ventricular arrhythmia, shock, cardiac arrest, etc., who need intravenous fat emulsion treatment;
3. Those who are not allergic to fat milk;
4. Sign informed consent.

Exclusion Criteria:

1. Mergers with insufficiency of important organs;
2. Patients with malignant tumors;
3. Severe mental disorder affects the treatment;
4. Those with incomplete clinical data.

Primary outcomes:
measure: mortality rate
timeFrame: 24 hours
Secondary outcomes:
measure: Circulatory system
timeFrame: 24 hours
measure: mortality rate
timeFrame: 1 week and 28 days
Other outcomes:
Locations:
Study officials:
References: