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Year : 2020  |  Volume : 25  |  Issue : 1  |  Page : 67

Efficacy of high-dose ambroxol for paraquat poisoning: A meta-analysis of randomized controlled trials

1 Department of Emergency Medicine, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
2 Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China

Correspondence Address:
Dr. Haitao Shen
Department of Emergency Medicine, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang 110004
People's Republic of China
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jrms.JRMS_484_19

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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 I2 value in Stata software (version 15.0). Four outcome indicators (hospital mortality, partial pressure of oxygen (PaO2), oxygenation index (PaO2/FiO2), 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 PaO2(weighted mean difference [WMD] = 13.73 [mmHg], 95% confidence interval [CI]: 8.68–18.79, Z = 11.80, P < 0.001), PaO2/FiO2(WMD = 38.81 [mmHg], 95% CI: 29.85–47.76, Z = 8.49, P = 0.000), and survival time of the deceased patients (WMD = 2.58 [d], 95% CI: 0.97–4.18, Z = 3.15, P = 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, P = 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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