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Gastric lavage for liquid poisons.
R Grierson1, R Green, D S Sitar
1Department of Emergency Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Annals of Emergency Medicine
|April 28, 2000
Summary
Gastric lavage performed one hour after ingesting acetaminophen significantly reduced its absorption. However, this method is unlikely to be clinically useful due to its modest and unreliable effects compared to activated charcoal.
Area of Science:
- Pharmacokinetics
- Toxicology
- Gastroenterology
Background:
- Gastric lavage is a procedure to remove ingested substances.
- Its effectiveness in reducing drug absorption is debated.
Purpose of the Study:
- To determine if gastric lavage reduces the absorption of ingested liquids.
- To assess the impact of gastric lavage on acetaminophen bioavailability.
Main Methods:
- Randomized controlled human volunteer crossover study (10 subjects).
- Volunteers ingested acetaminophen solution on two occasions.
- Gastric lavage was performed one hour after ingestion in one session.
- Serum acetaminophen concentrations were measured over 8 hours.
Main Results:
- Gastric lavage significantly decreased mean acetaminophen bioavailability by 20% (P < .05).
- Area under the concentration curve was reduced from 195+/-31 to 154+/-52 mg/L.hour.
- The 95% confidence interval for the reduction was 3% to 37%.
Conclusions:
- Gastric lavage at one hour post-ingestion reduces acetaminophen bioavailability in an experimental model.
- The clinical value is limited due to modest, unreliable effects.
- Activated charcoal is a more effective and safer alternative.