Compliance to whole bowel irrigation recommendations: a single poison center study

Figures & data

Table 1. Indications and contraindications for WBI [1].

Indications	Contraindications
Potentially toxic ingestions of sustained-release and modified release drugs	Airway protective reflexes are absent or expected to become so in a patient who is not intubated
Ingestion of a toxic amount of a xenobiotic that is not absorbed to activated charcoal when other methods of GI decontamination are not possible or not efficacious	GI tract is not intact. There are signs of ileus, obstruction, significant GI hemorrhage, or hemodynamic instability that might compromise GI motility
Removal of illicit drug packets from body packers	Signs of leakage from cocaine packets (indication for surgical removal)
	Persistent vomiting

Figure 1. Inclusion criteria for data collection and subsequent data abstraction and review process and analysis.

Table 2. Case characterstics, including age, gender, single vs. multiple substance ingestion, clinical outcomes, and xenobiotic ingested.

Characteristic	No WBI (n = 202)	WBI (n = 281)	P*	p-adj^Table Footnote†
Age, median (IQR)	34.5 (22-47)	31 (19.5-44.5)	0.25	.47
Gender, N (%)			0.63	.73
Male	109 (54.0)	157 (55.9)
Female	93(46.0)	124 (44.1)
Type of ingestion, N (%)			0.51	.70
Single substance	96 (47.5)	142 (50.5)
Multiple substance	106 (52.5)	139 (49.5)
Presence of intubation, N (%)			0.10	.38
Received intubation	40 (19.8)	40 (14.2)
Did not receive intubation	162 (80.2)	241 (85.8)
Clinical outcomes, N (%)			0.10	.38
No effect	40 (19.8)	43 (15.3)
Minor effect	49 (24.3)	101 (35.7)
Moderate effect	81 (40.1)	98 (34.6)
Major effect	30 (14.9)	36 (12.7)
Death	2 (1.0)	3 (1.1)
Xenobiotic ingested, N (%)
Calcium channel blocker	46 (22.8)	66 (23.5)	0.85	.85
Beta blocker	44 (21.8)	41 (14.6)	0.04	.38
Lithium	30 (14.9)	37 (13.2)	0.60	.73
Benzodiazepines	19 (9.4)	28 (10.0)	0.84	.85
Cocaine	14 (6.9)	26 (9.3)	0.36	.54
Bupropion	9 (4.5)	21 (7.5)	0.18	.45
Atypical antipsychotic	19 (9.4)	15 (5.3)	0.09	.38
Iron containing products	10 (5.0)	24 (8.5)	0.13	.39
Methamphetamines	17 (8.4)	33 (11.7)	0.24	.47
Antidepressants	22 (10.9)	23 (8.2)	0.31	.52

* P value computed from a Mann-Whitney U or χ² test.

† P value following the false discovery rate correction.

Figure 2. Compliance rates based on Xenobiotic ingested.

Figure 3. Clinical Effects By Compliance to WBI Recommendations by PC.

Figure 4. WBI Compliance rate by year.

Hoegberg L, Nelson L, Howland MA, et al. Techniques used to prevent gastroinetestinal absorption. In Goldfrank’s toxicologic emergencies. 11th ed. McGraw-Hill Medical; 2019. p. 48–70.

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