Experimental Evaluation Of The Therapeutic Effect Of Activated Charcoal In Oral Poisoning Of Common Chemicals

Incidents caused by oral poisoning of chemicals have led to great harm to China. However,fatality might be cut down,if removal measures were taken promptly at the early stage of poisoning.Activated charcoal is the most favorable chioce of gut decontamination abroad while intoxication happened because of its excellent adsorption efficacy,rare side effects and feasibility of pre-hospital treatment.The existing problem lies in that few systematic review or large sample RCT have been carried out on the adsorbing efficacy of the common chemicals by activated charcoal at home and abroad.It is,therefore,impossible to confirm the therapeutic effect as well as the degree of effect of activated charcoal in oral poisoning of common chemicals.The present study includes three parts as follows:(1) Browse all documents related to the adsorbing efficacy of activated charcoal on chemicals that may bring to oral poisoning incidents,summarize results of those documents systematically and focus on the indefinite conclusion(such as rodenticide and nitrite) to find out subjects to be studied the therapeutic effect in vitro and in vivo;(2)The adsorption effect of activated charcoal on nitrite were studied in vitro while the therapeutic effect of activated charcoal on rats intoxicated with nitrite of lethal dose as well as toxic dose were studied in vivo;(3)The adsorption effect of activated charcoal on bromadiolone were studied in vitro and in vivo,too.Results showed that,(1) only a few articles focusing on the adsorbing efficacy of common chemicals by activated charcoal were found,and most of which were designed imperfectly and explained inappropriately.It remained uncertain that whether activated charcoal should be used or not when oral sodium nitrite and bromadiolone poisoning incidents,two of common chemicals that may lead to oral poisoning incidents in China,break out.It's the basis of subject selected of the present study,to evaluate the adsorptive efficacy of activated charcoal in vitro and in vivo;(2) As the in vitro study had found,sodium nitrite could be adsorbed by activated charcoal,with the adsorption rate influenced by the activated charcoal-sodium nitrite ratio significantly but not by pH.The animal study,however, showed that neither convulsion alleviated or delayed,nor mortality rate or the blood metahemoglobin was decreased when activated charcoal was used;(3) The concentration of bromadiolone in each activated charcoal group was all brought down below the detection limit in vitro,which proved the effective adsorption of activated charcoal on bromadiolone.But as to animal study,the PT,APTT and mortality rate showed no improvement when activated charcoal was used for the rabbits intoxicated with bromadiolone of lethal dose,though the plasma concentration of bromadiolone did have been cut down significantly.In conclusion,we suggest that activated charcoal would not be used as conventional treatment in oral sodium nitrites poisoning.On the other hand,more studies on the therapeutic effect of activated charcoal in bromadiolone poisoning of toxic dose as well as the therapeutic effect of multi-dose activated charcoal in bromadiolone poisoning should be carried out.