Author/Yr |
Study type |
Study vs. Control |
N |
Mortality |
Secondary Endpoint(s) |
Significance |
Spiller 2007 |
Retrospective
APAP |
AC+NAC vs. NAC |
97,960 |
0.5% vs.
0.8% |
↓ AST/ALT>1000 AC 2.9% vs. 12% |
SDAC saves lives, ↓ liver damage |
Spiller 2006 |
Prospective
APAP divided by time to NAC |
AC+NAC vs. NAC 4-8hrs, 9-12hrs and 13-16hrs |
145 |
None |
↓ AST or ALT >1,000 4-8h 0% vs. 11.7% 9-12h 2.7% vs. 52%
13-16h 10% vs. 45% |
↑ Effect of AC when NAC started later |
Cooper 2005 |
Prospective
All ODs |
AC vs. No AC |
327 |
0.3% |
1° LOS, no dif
2° vomit/aspiration/ICU no dif |
Low acuity, severe ODs and <1hr excluded |
Merigian 2002 |
Prospective
All OD |
AC vs. No AC |
1479 |
None |
1° LOS, no dif
2° clinical worse/emesis ↓Emesis- AC 25% v no AC 14% |
Subjective endpt. Low acuity 86% discharged, |
Buckley 1999 |
Retrospective
APAP |
AC 1-2g/kg vs.
GL+AC vs.
control |
981 |
None |
↓ risk of hepatoxicity AC 12.9% AC+GL 14.2% control 29.9% |
AC↓ serum toxicity, GL no benefit |
Kornberg 1991 |
Prospective
Children |
AC vs.
SOI + AC |
70 |
None |
Less emesis and shorter LOS w AC |
SOI ↑ side effects, delays AC |
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Underhill 1990 |
Prospective APAP |
AC vs. GL vs. SOI |
60 |
None |
% fall in serum [APAP] AC 52 GL39 SOI 41 |
AC > GL or SOI if <2hrs |
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Abbreviations: AC:Activated Charcoal; APAP:Acetaminophen/Paracetamol; AST/ALT:Transaminases; G:Grams; GL:Gastric Lavage; H:Hours; ICU:Intensive Care Unit; Kg:Kilograms; LOS:Length of Stay; N:Number of Patients; NAC:N-Acetylcysteine; OD:Overdose; SOI:Syrup of Ipecac; ↑:Increase; ↓:Decrease |
