DISCUSSION
Summary of main
results
The currently available evidence
from 4 RCTs ( 39) (40) (41) (42) indicates that GL with
paraffin oil is an effective treatment for acute AlP
poisoning, decreasing the mortality rate compared with the
standard therapy (RR = 0.62 ; 95%CI = 0.48 to 0.81 ;
participants = 226; I2=10%;low-quality
evidence). In the subgroup
analysis, this effect was only maintained among those participants with
the longest latency (≥ 2 hs) of AlP exposure (RR =
0.50 ; 95% CI= 0.34 to 0.74; participants=124; studies = 2;
very low-quality
evidence ). However, these results are probably influenced by the small
number of clinical trials, possibly unsuitable for performing a subgroup
analysis or for a meta-regression.
Likewise, the evidence indicates
that this intervention reduces the need for intubation and
mechanical ventilation (RR = 0.62 ; 95%CI = 0.40 to
0.79 ; participants= 226; I2 = 0%;low-quality
evidence) . These benefits have not been reflected in thelength of hospital stay (MD= 10.73; 95%CI = -2.28 to 23.74;
I2 = 65%). The level of heterogeneity could be
explained by the results of one of the trials, in which the duration of
hospital stay was significantly longer in the paraffin oil
group because of a higher percentage of survivors (39). The exclusion
of this trial gives an MD of 5.64 (95% CI -2.20 to 13.47) decreasing
the level of heterogeneity (I2 = 33%).
Finally, the need for vasopressors was lower among the
participants who received GL with paraffin oil ( RR=0.76 ; 95%CI= 0.61 to 0.94; studies= 3;I2= 1%; low-quality evidence )
We calculated an NNT from the mortality rate of GL withparaffin oil (38.9% in the paraffin oil versus 66.4% in the
control group), estimating an NNT of 4 (3.6).
Regarding GL with coconut
oil , the available evidence from 4 RCTs (37)(38)(42)(43),
indicates a slight reduction in mortality in patients with
acute AlP poisoning (RR= 0.82 ; 95%CI = 0.69 to 0.98 ;
participants= 112; I 2= 0%;
very low-quality
evidence ). Again, through the subgroup analysis, this effect was only
observed among those with more than 2 hs latency from AlP
exposure (RR= 0.78 ; 95%CI = 0.64 to 0.96; studies =
3; very low-quality evidence ). This effect was not
reflected in the other outcomes considered.