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Urinary alkalinisation for acute chlorophenoxy herbicide poisoning
1Medical School, Australian National University, South Asian Clinical Toxicology Research Collaboration, Canberra, Australian Capital Territory, Australia, 0200. dmroberts@iprimus.com.au
The Cochrane Database of Systematic Reviews
|January 27, 2007
Summary
Urinary alkalinisation is not proven effective for acute chlorophenoxy herbicide poisoning. More research, specifically randomized controlled trials, is needed to determine its efficacy and appropriate use.
Area of Science:
- Toxicology
- Clinical Pharmacology
- Emergency Medicine
Background:
- Acute poisoning from chlorophenoxy herbicides (e.g., 2,4-D, MCPA) is a global health concern.
- Animal studies and case reports suggest urinary alkalinisation may aid herbicide excretion and improve outcomes.
- Sodium bicarbonate is a commonly considered agent for urinary alkalinisation.
Purpose of the Study:
- To evaluate the effectiveness of urinary alkalinisation, specifically with sodium bicarbonate.
- To assess its role in treating acute poisoning by chlorophenoxy herbicides.
Main Methods:
- Comprehensive literature search of multiple databases (MEDLINE, EMBASE, CENTRAL, etc.) and expert consultation.
- Inclusion criteria focused on randomized controlled trials in patients presenting within 24-48 hours of poisoning.
- Data extraction included study design, participant characteristics, interventions, and outcomes, with quality assessment.
Main Results:
- No randomized controlled trials met the inclusion criteria for this review.
- The search yielded no studies suitable for assessing the efficacy of urinary alkalinisation in this context.
Conclusions:
- Current evidence is insufficient to recommend routine urinary alkalinisation for acute chlorophenoxy herbicide poisoning.
- A high-quality randomized controlled trial is essential to establish efficacy and indications for this treatment.
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