Effectiveness of Fresh Frozen Plasma in Management of Acute Organophosphate Intoxicated Patients: An Updated Systematic Review and Meta-Analysis

Organophosphate (OP) poisoning is still a major health concern in both developed and developing countries. The standard treatment approaches of (OP) poisoning are not always available as well so they may show a limited success rate. Fresh frozen plasma (FFP) is one of Bio-scavengers that have been suggested as a useful therapy through elimination of free organophosphates. Therefore, this systematic review and meta-analysis was conducted to update the present evidence about the efficacy of FFP in management of acute OP-intoxicated patients. A computer literature search of PubMed and Scopus was conducted to identify the relevant randomized controlled trials (RCTs). In addition, a manual search of reference lists of the retrieved articles was conducted. Relevant outcomes were pooled as mean difference (MD) risk ratio (RR) by RevMan version 5.3 for Windows. Pooled data from 3 RCTs (169 patients) showed that adding FFP to conventional therapy to acutely OP intoxicated patients did not improve clinical outcomes regarding total atropine (MD = 35.05, 95% CI = [-41.14 to 111.24], P-value = 0.37) and pralidoxime dosages (MD = -0.41, 95% CI = [-2.34 to 1.51], P-value = 0.67), length of hospital stay (MD = -2.08, 95% CI = [-4.51 to 0.35], P-value = 0.09) and mortality (RR = 0.42, 95% CI = [0.14 to 1.27], P-value = 0.12). Fresh frozen plasma did not provide any additional benefit in acutely-OP intoxicated patients compared to the conventional therapy. The limited number and sizes of the included trials are the most probable cause of such effects.