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Abstract：
BACKGROUND: Acute liver failure caused by the ingestion of yellow phosphorus-containing rodenticide has been increasing in incidence over the last decade and is a common indication for emergency liver transplantation in Southern and Western India and other countries. Clear guidelines for its management are necessary, given its unpredictable course, potential for rapid deterioration and variation in clinical practice.
METHODS: A modified Delphi approach was used for developing consensus guidelines under the aegis of the Liver Transplantation Society of India. A detailed review of the published literature was performed. Recommendations for three areas of clinical practice, assessment and initial management, intensive care unit (ICU) management and liver transplantation, were developed.
RESULTS: The expert panel consisted of 16 clinicians, 3 nonclinical specialists and 5 senior advisory members from 11 centres. Thirty-one recommendations with regard to criteria for hospital admission and discharge, role of medical therapies, ICU management, evidence for extracorporeal therapies such as renal replacement therapy and therapeutic plasma exchange, early predictors of need for liver transplantation and perioperative care were developed based on published evidence and combined clinical experience.
CONCLUSIONS: Development of these guidelines should help standardise care for patients with yellow phosphorus poisoning and identify areas for collaborative research.
METHODS: A modified Delphi approach was used for developing consensus guidelines under the aegis of the Liver Transplantation Society of India. A detailed review of the published literature was performed. Recommendations for three areas of clinical practice, assessment and initial management, intensive care unit (ICU) management and liver transplantation, were developed.
RESULTS: The expert panel consisted of 16 clinicians, 3 nonclinical specialists and 5 senior advisory members from 11 centres. Thirty-one recommendations with regard to criteria for hospital admission and discharge, role of medical therapies, ICU management, evidence for extracorporeal therapies such as renal replacement therapy and therapeutic plasma exchange, early predictors of need for liver transplantation and perioperative care were developed based on published evidence and combined clinical experience.
CONCLUSIONS: Development of these guidelines should help standardise care for patients with yellow phosphorus poisoning and identify areas for collaborative research.
摘要：
背景：在过去的十年中，摄入含黄磷的杀鼠剂引起的急性肝衰竭的发病率一直在增加，并且是印度南部和西部及其他国家紧急肝移植的常见指征。其管理需要明确的指导方针,鉴于其不可预测的过程，在临床实践中迅速恶化和变化的可能性。
方法：在印度肝移植学会的主持下，采用改良的Delphi方法制定共识指南。对已发表的文献进行了详细的回顾。关于临床实践三个领域的建议，评估和初始管理，重症监护病房（ICU）管理和肝移植，是开发的。
结果：专家小组由16名临床医生组成，来自11个中心的3名非临床专家和5名高级顾问。关于入院和出院标准的31项建议,药物治疗的作用，ICU管理,体外治疗的证据，如肾脏替代疗法和治疗性血浆置换，根据已发表的证据和结合的临床经验,制定了需要肝移植和围手术期护理的早期预测因子.
结论：制定这些指南应有助于规范黄磷中毒患者的护理，并确定合作研究领域。
方法：在印度肝移植学会的主持下，采用改良的Delphi方法制定共识指南。对已发表的文献进行了详细的回顾。关于临床实践三个领域的建议，评估和初始管理，重症监护病房（ICU）管理和肝移植，是开发的。
结果：专家小组由16名临床医生组成，来自11个中心的3名非临床专家和5名高级顾问。关于入院和出院标准的31项建议,药物治疗的作用，ICU管理,体外治疗的证据，如肾脏替代疗法和治疗性血浆置换，根据已发表的证据和结合的临床经验,制定了需要肝移植和围手术期护理的早期预测因子.
结论：制定这些指南应有助于规范黄磷中毒患者的护理，并确定合作研究领域。
