Effect of acetylcysteine on prothrombin index in paracetamol poisoning without hepatocellular injury

Lars E Schmidt; Tore Tveit Knudsen; Kim Dalhoff; Flemming Bendtsen

doi:10.1016/S0140-6736(02)11194-9

Effect of acetylcysteine on prothrombin index in paracetamol poisoning without hepatocellular injury

Lars E Schmidt, Tore Tveit Knudsen, Kim Dalhoff, Flemming Bendtsen

49 Citations (Scopus)

Abstract

Acetylcysteine treatment reduces liver damage after paracetamol overdose, but can affect the prothrombin index, which is used to assess the progress of overdose patients. We aimed to assess retrospectively the effect of intravenous acetylcysteine on the prothrombin index in patients with paracetamol poisoning without signs of hepatocellular injury. Prothrombin index had been recorded before, and serially during, acetylcysteine treatment in 87 patients. After initiation of treatment, prothrombin index decreased (mean 0.33, 95% CI 0.29-0.38) in all patients, and was strongly associated with the start of acetylcysteine infusion. In patients with uncomplicated paracetamol poisoning, a fall in this index might be misinterpreted as a sign of liver failure, leading to prolonged treatment time.

Original language	English
Journal	Lancet
Volume	360
Issue number	9340
Pages (from-to)	1151-2
Number of pages	2
ISSN	0140-6736
DOIs	https://doi.org/10.1016/S0140-6736(02)11194-9
Publication status	Published - 12 Oct 2002

Keywords

Acetaminophen
Acetylcysteine
Adolescent
Adult
Aged
Aged, 80 and over
Antidotes
Chemical and Drug Induced Liver Injury
Diagnosis, Differential
Drug Overdose
Female
Humans
Infusions, Intravenous
Liver Failure
Male
Middle Aged
Prothrombin Time
Retrospective Studies
Journal Article

Access to Document

10.1016/S0140-6736(02)11194-9

Cite this

@article{649c6b9eda234eaca940c38b12b9587f,

title = "Effect of acetylcysteine on prothrombin index in paracetamol poisoning without hepatocellular injury",

abstract = "Acetylcysteine treatment reduces liver damage after paracetamol overdose, but can affect the prothrombin index, which is used to assess the progress of overdose patients. We aimed to assess retrospectively the effect of intravenous acetylcysteine on the prothrombin index in patients with paracetamol poisoning without signs of hepatocellular injury. Prothrombin index had been recorded before, and serially during, acetylcysteine treatment in 87 patients. After initiation of treatment, prothrombin index decreased (mean 0.33, 95% CI 0.29-0.38) in all patients, and was strongly associated with the start of acetylcysteine infusion. In patients with uncomplicated paracetamol poisoning, a fall in this index might be misinterpreted as a sign of liver failure, leading to prolonged treatment time.",

keywords = "Acetaminophen, Acetylcysteine, Adolescent, Adult, Aged, Aged, 80 and over, Antidotes, Chemical and Drug Induced Liver Injury, Diagnosis, Differential, Drug Overdose, Female, Humans, Infusions, Intravenous, Liver Failure, Male, Middle Aged, Prothrombin Time, Retrospective Studies, Journal Article",

author = "Schmidt, {Lars E} and Knudsen, {Tore Tveit} and Kim Dalhoff and Flemming Bendtsen",

year = "2002",

month = oct,

day = "12",

doi = "10.1016/S0140-6736(02)11194-9",

language = "English",

volume = "360",

pages = "1151--2",

journal = "Lancet",

issn = "0140-6736",

publisher = "The/Lancet Publishing Group",

number = "9340",

}

TY - JOUR

T1 - Effect of acetylcysteine on prothrombin index in paracetamol poisoning without hepatocellular injury

AU - Schmidt, Lars E

AU - Knudsen, Tore Tveit

AU - Dalhoff, Kim

AU - Bendtsen, Flemming

PY - 2002/10/12

Y1 - 2002/10/12

N2 - Acetylcysteine treatment reduces liver damage after paracetamol overdose, but can affect the prothrombin index, which is used to assess the progress of overdose patients. We aimed to assess retrospectively the effect of intravenous acetylcysteine on the prothrombin index in patients with paracetamol poisoning without signs of hepatocellular injury. Prothrombin index had been recorded before, and serially during, acetylcysteine treatment in 87 patients. After initiation of treatment, prothrombin index decreased (mean 0.33, 95% CI 0.29-0.38) in all patients, and was strongly associated with the start of acetylcysteine infusion. In patients with uncomplicated paracetamol poisoning, a fall in this index might be misinterpreted as a sign of liver failure, leading to prolonged treatment time.

AB - Acetylcysteine treatment reduces liver damage after paracetamol overdose, but can affect the prothrombin index, which is used to assess the progress of overdose patients. We aimed to assess retrospectively the effect of intravenous acetylcysteine on the prothrombin index in patients with paracetamol poisoning without signs of hepatocellular injury. Prothrombin index had been recorded before, and serially during, acetylcysteine treatment in 87 patients. After initiation of treatment, prothrombin index decreased (mean 0.33, 95% CI 0.29-0.38) in all patients, and was strongly associated with the start of acetylcysteine infusion. In patients with uncomplicated paracetamol poisoning, a fall in this index might be misinterpreted as a sign of liver failure, leading to prolonged treatment time.

KW - Acetaminophen

KW - Acetylcysteine

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Antidotes

KW - Chemical and Drug Induced Liver Injury

KW - Diagnosis, Differential

KW - Drug Overdose

KW - Female

KW - Humans

KW - Infusions, Intravenous

KW - Liver Failure

KW - Male

KW - Middle Aged

KW - Prothrombin Time

KW - Retrospective Studies

KW - Journal Article

U2 - 10.1016/S0140-6736(02)11194-9

DO - 10.1016/S0140-6736(02)11194-9

M3 - Journal article

C2 - 12387966

SN - 0140-6736

VL - 360

SP - 1151

EP - 1152

JO - Lancet

JF - Lancet

IS - 9340

ER -

Effect of acetylcysteine on prothrombin index in paracetamol poisoning without hepatocellular injury

Abstract

Keywords

Access to Document

Fingerprint

Cite this