Background: Paraquat (PQ) poisoning is characterized by rapidly progressive acute poisoning with high mortality and no specific antidote. Although some clinical studies have been conducted to investigate the benefits of high-dose ambroxol as an adjuvant treatment for PQ poisoning, the efficacy is controversial.
Materials And Methods: After searching for relevant articles in English and Chinese databases from 1978 to 2019 according to the keywords (paraquat poisoning/methy viologen/gramoxone, and ambroxol/mucosolvan/Bromhexine), we found seven articles that met our inclusion and exclusion criteria. A meta-analysis was performed using fixed-effects model and random-effects model according to the value in Stata software (version 15.0). Four outcome indicators (hospital mortality, partial pressure of oxygen (PaO), oxygenation index (PaO/FiO), and survival time of the deceased patients) were of interest to us.
Results: The meta-analysis showed that adjuvant treatment with high doses of ambroxol increased PaO (weighted mean difference [WMD] = 13.73 [mmHg], 95% confidence interval [CI]: 8.68-18.79, = 11.80, < 0.001), PaO/FiO (WMD = 38.81 [mmHg], 95% CI: 29.85-47.76, = 8.49, = 0.000), and survival time of the deceased patients (WMD = 2.58 [], 95% CI: 0.97-4.18, = 3.15, = 0.002) compared with usual treatment. Treatment with high doses of ambroxol also appeared to reduce the hospital mortality (relative risk = 0.69, 95% CI: 0.55-0.86, Z = 3.25, = 0.001).
Conclusion: This study found that high-dose ambroxol is an effective therapy for PQ poisoning and may reduce the in-hospital mortality.
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| http://dx.doi.org/10.4103/jrms.JRMS_484_19 | DOI Listing |
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