Elsevier

The Lancet

Volume 360, Issue 9340, 12 October 2002, Pages 1151-1152
The Lancet

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

https://doi.org/10.1016/S0140-6736(02)11194-9Get rights and content

Summary

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% Cl 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.

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