Effectiveness of Fresh Frozen Plasma in Management of Acute Organophosphate Intoxicated Patients: An Updated Systematic Review and Meta-Analysis

Background:Organophosphate (OP) poisoning is still a major health concern in both developed and developing countries. The standard treatment approaches of (OP) poisoning are not always available as well so they may show a limited success rate. Fresh frozen plasma (FFP) is one of Bio-scavengers that have been suggested as a useful therapy through elimination of free organophosphates. Therefore, this systematic review and meta-analysis was conducted to update the present evidence about the efficacy of FFP in management of acute OP-intoxicated patients. Method:A computer literature search of PubMed and Scopus was conducted to identify the relevant randomized controlled trials (RCTs). In addition, a manual search of reference lists of the retrieved articles was conducted. Relevant outcomes were pooled as mean difference (MD) risk ratio (RR) by RevMan version 5.3 for Windows. Results:Pooled data from 3 RCTs (169 patients) showed that adding FFP to conventional therapy to acutely OP intoxicated patients did not improve clinical outcomes regarding total atropine (MD = 35.05, 95% CI = [-41.14 to 111.24], P-value = 0.37) and pralidoxime dosages (MD = -0.41, 95% CI = [-2.34 to 1.51], P-value = 0.67), length of hospital stay (MD = -2.08, 95% CI = [-4.51 to 0.35], P-value = 0.09) and mortality (RR = 0.42, 95% CI = [0.14 to 1.27], P-value = 0.12). Conclusion: Fresh frozen plasma did not provide any additional benefit in acutely-OP intoxicated patients compared to the conventional therapy. The limited number and sizes of the included trials are the most probable cause of such effects.

Keywords:

Atropine , Fresh Frozen Plasma , Meta-analysis , Organophosphate , Pralidoxime