Please use this identifier to cite or link to this item: https://observatorio.fm.usp.br/handle/OPI/549
Title: The EXTRIP (EXtracorporeal TReatments In Poisoning) workgroup: Guideline methodology
Authors: LAVERGNE, ValeryNOLIN, Thomas D.HOFFMAN, Robert S.ROBERTS, DarrenGOSSELIN, SophieGOLDFARB, David S.KIELSTEIN, Jan T.MACTIER, RobertMACLAREN, RobertMOWRY, James B.BUNCHMAN, Timothy E.JUURLINK, DavidMEGARBANE, BrunoANSEEUW, KurtWINCHESTER, James F.DARGAN, Paul I.LIU, Kathleen D.HOEGBERG, Lotte C.LI, YiCALELLO, Diane P.BURDMANN, Emmanuel A.YATES, ChristopherLALIBERTE, MartinDECKER, Brian ScottMELLO-DA-SILVA, Carlos AugustoLAVONAS, EricGHANNOUM, Marc
Citation: CLINICAL TOXICOLOGY, v.50, n.5, p.403-413, 2012
Abstract: Extracorporeal treatments (ECTRs), such as hemodialysis and hemoperfusion, are used in poisoning despite a lack of controlled human trials demonstrating efficacy. To provide uniform recommendations, the EXTRIP group was formed as an international collaboration among recognized experts from nephrology, clinical toxicology, critical care, or pharmacology and supported by over 30 professional societies. For every poison, the clinical benefit of ECTR is weighed against associated complications, alternative therapies, and costs. Rigorous methodology, using the AGREE instrument, was developed and ratified. Methods rely on evidence appraisal and, in the absence of robust studies, on a thorough and transparent process of consensus statements. Twenty-four poisons were chosen according to their frequency, available evidence, and relevance. A systematic literature search was performed in order to retrieve all original publications regardless of language. Data were extracted on a standardized instrument. Quality of the evidence was assessed by GRADE as: High = A, Moderate = B, Low = C, Very Low = D. For every poison, dialyzability was assessed and clinical effect of ECTR summarized. All pertinent documents were submitted to the workgroup with a list of statements for vote (general statement, indications, timing, ECTR choice). A modified Delphi method with two voting rounds was used, between which deliberation was required. Each statement was voted on a Likert scale (1-9) to establish the strength of recommendation. This approach will permit the production of the first important practice guidelines on this topic.
Appears in Collections:Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - LIM/12

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