The Poison Lab

2022 North American Congress of Clinical Toxicology (NACCT) High Yield Abstract Review

Episode Summary

In this episode Ryan is joined by a guest panel to review 15 of the most clinically impactful research abstracts that were presented at the 2022 North American Congress of Clinical Toxicology (NACCT) in San Francisco. If you didn't get a chance to read all 312 research abstracts from some of Toxicology's best and brightest this year, tune in for a high yield review as well as clinical a break down of the studies and their relevance from the expert panel (Dr. Grant Comstock MD, Dr. Daniel McCabe MD, and Dr. Natalija Farrel PharmD, DABAT). Check the show notes for a link to the published abstracts and the list of all studies discussed in the show.

Episode Notes

All published abstracts can be found here 

Abstracts

1. Category 1: Amlodipine Vasoplegia
   • Abstract 1: Vasodilation in patients with calcium channel blocker poisoning treated with high dose insulin: a comparison of amlodipine versus non-dihydropyridines
     • Study of HDI on propranolol poisoned pigs
     • Study of Minnesota HDI protocol
   • Abstract 2: Amlodipine anxiety: a 10-year review of amlodipine associated fatalities
   • Abstract 3: Extracorporeal membrane oxygenation utilization for vasoplegic shock due to pediatric toxic ingestions
     • Data of ECMO in poisoning
2. Category 2: Xylazine
   • Abstract 4: “Tranq dope” opioid overdose: clinical outcomes for emergency department patients with illicit opioid overdose adulterated with xylazine
3. Category 3: Case Reports with Terrifying Clinical Implications
   • Abstract 5: Recovery after poly-drug overdose despite blood flow imaging demonstrating no brain perfusion
   • Abstract 6: Challenges in diagnosing an environmental cause of recurrent methemoglobinemia
   • Abstract 7: Acute thiamine deficiency as a complication of insulin euglycemic therapy for an amlodipine overdose
4. Category 4: Comparative evidence, Prognostication, and Triage
   • Abstract 8: Utility of pre four-hour iron concentration in predicting toxicology
   • Abstract 9: Andexanet alfa vs 4-factor prothrombin complex concentrate for intracranial hemorrhage at a level I trauma hospital
5. Category 5: Rapid Review
   • Abstract 10: Fentanyl and fentanyl analogue exposure among emergency personnel and first responders: a systematic review
   • Abstract 11: Significance of falsely low creatinine values in diagnosing massive acetaminophen ingestion
   • Abstract 12: Large dose intentional ciprofloxacin ingestion associated with false-positive urine immunoassay for oxycodone and fentanyl
   • Abstract 13: Don’t make it a double?: a 20- year review of supratherapeutic amlodipine ingestions while on chronic therapy
   • Abstract 14: Evaluation of pediatric lisdexamfetamine exposures reported to a statewide poison control system
   • Abstract 15: An assessment of the reliability of stated quantity in acute acetaminophen overdoses reported to a regional poison center