Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment

Background and objective. Paracetamol poisoning can be serious and require treatment with N-acetylcysteine (NAC). A dose of 300 mg/kg is usually given in 3 fractions over 21 hours. An alternative regimen, the Scottish and Newcastle Acetylcysteine Protocol (SNAP), specifies the same total dose given...

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Autores: Supervia, A, Gispert, MA, Puiguriguer, J, Zabala, PBA, Sánchez, LM, Olmos, S, Calderón, B, Picornell, RD, Nogué, S, Córdoba, F
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Recursos:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p6332
Acesso em linha:https://i3pt.portalinvestigacion.com/publicaciones/6332
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85217828557&doi=10.55633%2Fs3me%2F100.2024&partnerID=40&md5=9593d92ac8d780ccc88521adbdac8180
Access Level:acceso abierto
Palavra-chave:Acetaminophen
Paracetamol
Scottish and Newcastle Acetylcysteine Protocol
Poisoning
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spelling Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatmentSupervia, AGispert, MAPuiguriguer, JZabala, PBASánchez, LMOlmos, SCalderón, BPicornell, RDNogué, SCórdoba, FAcetaminophenParacetamolScottish and Newcastle Acetylcysteine ProtocolPoisoningBackground and objective. Paracetamol poisoning can be serious and require treatment with N-acetylcysteine (NAC). A dose of 300 mg/kg is usually given in 3 fractions over 21 hours. An alternative regimen, the Scottish and Newcastle Acetylcysteine Protocol (SNAP), specifies the same total dose given in 2 intravenous injections over 12 hours. This study aimed to compare the 2 regimens in terms of effectiveness, adverse events, and lengths of emergency department (ED) and hospital stays. Methods. Prospective multicenter study to compare outcomes associated with the traditional NAC regimen vs SNAP. We enrolled all patients with paracetamol poisoning requiring NAC treatment in the participating hospital EDs from 2021 through 2023. Data related to referrals, poisoning episodes, and discharge destinations were collected. Patients were studied in 2 groups according to the protocol assigned in the EDs. Results. A total of 165 patients were treated (SNAP, 103; traditional protocol, 62). The mean (SD) age was 28.1 (19.7) years, and most were female (70.5%). No differences in peak transaminase levels were observed. SNAP-treated patients had significantly fewer adverse effects as well as shorter stays both in the ED (17.8 [15.2] hours vs 25.9 [17.1] hours; P = .001) and on the ward (2.6 [2.3] days vs 4.4 [3.6] days; P = .019). Conclusions. Fewer adverse events occurred with the SNAP approach. The 2 protocols were similarly effective. The SNAP-treated patients spent less time in the ED, and those who were admitted to hospital had shorter stays.Soc Espanola Medicina Urgencias & Emergencias-SEMES2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/6332https://www.scopus.com/inward/record.uri?eid=2-s2.0-85217828557&doi=10.55633%2Fs3me%2F100.2024&partnerID=40&md5=9593d92ac8d780ccc88521adbdac8180EmergenciasISSN: 11376821ISSNe: 23865857reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Españolinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p63322026-06-21T15:30:37Z
dc.title.none.fl_str_mv Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
title Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
spellingShingle Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
Supervia, A
Acetaminophen
Paracetamol
Scottish and Newcastle Acetylcysteine Protocol
Poisoning
title_short Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
title_full Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
title_fullStr Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
title_full_unstemmed Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
title_sort Paracetamol poisoning: a prospective comparison of 2 protocols for N-acetylcysteine treatment
dc.creator.none.fl_str_mv Supervia, A
Gispert, MA
Puiguriguer, J
Zabala, PBA
Sánchez, LM
Olmos, S
Calderón, B
Picornell, RD
Nogué, S
Córdoba, F
author Supervia, A
author_facet Supervia, A
Gispert, MA
Puiguriguer, J
Zabala, PBA
Sánchez, LM
Olmos, S
Calderón, B
Picornell, RD
Nogué, S
Córdoba, F
author_role author
author2 Gispert, MA
Puiguriguer, J
Zabala, PBA
Sánchez, LM
Olmos, S
Calderón, B
Picornell, RD
Nogué, S
Córdoba, F
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Acetaminophen
Paracetamol
Scottish and Newcastle Acetylcysteine Protocol
Poisoning
topic Acetaminophen
Paracetamol
Scottish and Newcastle Acetylcysteine Protocol
Poisoning
description Background and objective. Paracetamol poisoning can be serious and require treatment with N-acetylcysteine (NAC). A dose of 300 mg/kg is usually given in 3 fractions over 21 hours. An alternative regimen, the Scottish and Newcastle Acetylcysteine Protocol (SNAP), specifies the same total dose given in 2 intravenous injections over 12 hours. This study aimed to compare the 2 regimens in terms of effectiveness, adverse events, and lengths of emergency department (ED) and hospital stays. Methods. Prospective multicenter study to compare outcomes associated with the traditional NAC regimen vs SNAP. We enrolled all patients with paracetamol poisoning requiring NAC treatment in the participating hospital EDs from 2021 through 2023. Data related to referrals, poisoning episodes, and discharge destinations were collected. Patients were studied in 2 groups according to the protocol assigned in the EDs. Results. A total of 165 patients were treated (SNAP, 103; traditional protocol, 62). The mean (SD) age was 28.1 (19.7) years, and most were female (70.5%). No differences in peak transaminase levels were observed. SNAP-treated patients had significantly fewer adverse effects as well as shorter stays both in the ED (17.8 [15.2] hours vs 25.9 [17.1] hours; P = .001) and on the ward (2.6 [2.3] days vs 4.4 [3.6] days; P = .019). Conclusions. Fewer adverse events occurred with the SNAP approach. The 2 protocols were similarly effective. The SNAP-treated patients spent less time in the ED, and those who were admitted to hospital had shorter stays.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/6332
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85217828557&doi=10.55633%2Fs3me%2F100.2024&partnerID=40&md5=9593d92ac8d780ccc88521adbdac8180
url https://i3pt.portalinvestigacion.com/publicaciones/6332
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85217828557&doi=10.55633%2Fs3me%2F100.2024&partnerID=40&md5=9593d92ac8d780ccc88521adbdac8180
dc.language.none.fl_str_mv Español
language_invalid_str_mv Español
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Soc Espanola Medicina Urgencias & Emergencias-SEMES
publisher.none.fl_str_mv Soc Espanola Medicina Urgencias & Emergencias-SEMES
dc.source.none.fl_str_mv Emergencias
ISSN: 11376821
ISSNe: 23865857
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,30052

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