Role of Hemodialysis in Acute Severe Alcohol Intoxication: A Meta-Analysis

Abstract

Background: Hemodialysis therapy has been used in the treatment of acute alcohol intoxication for many years, especially acute severe alcohol intoxication. Objectives: This study aimed to evaluate whether the combination of conventional treatment and naloxone with hemodialysis has advantages over conventional treatment and naloxone alone in patients with acute severe alcohol intoxication. Methods: After searching 12 databases and 2 clinical trial centers. According to the established inclusion and exclusion criteria, the qualified literatures were screened. The outcome indicators were length of hospital stay, coma time, time of symptom disappearance, the overall complication rate, the incidence of pancreatitis, the incidence of aspiration pneumonia, the incidence of hepatic and renal dysfunction. Analysis was performed using Revman 5.3. Results: This meta-analysis included 13 studies, including 932 subjects. In the treatment of acute severe alcohol intoxication, the use of hemodialysis on the basis of conventional treatment and naloxone could reduce the length of hospital stay (WMD = −15.16, 95% CI: −17.45 to −12.86, p < 0.001) in hours and (WMD = −4.89, 95% CI: −5.53 to −4.25, p < 0.001) in days; coma time (WMD = −5.43, 95% CI: −6.43 to −4.43, p < 0.001); time of symptom disappearance (WMD = −3.92, 95% CI: −5.37 to −2.47, p < 0.001); the overall complication rate (RR = 0.39, 95% CI: 0.28–0.55, p < 0.001); the incidence of pancreatitis (RR = 0.14, 95% CI: 0.05–0.43, p = 0.0006); the incidence of aspiration pneumonia (RR = 0.15, 95% CI: 0.04–0.66, p = 0.01), and the incidence of hepatic and renal dysfunction (RR = 0.21, 95% CI: 0.06–0.72, p = 0.01). Conclusions: It can be concluded that compared with the use of conventional treatment and naloxone alone, the use of hemodialysis on the basis of conventional treatment and naloxone for acute severe alcohol intoxication can reduce the length of hospital stay, coma time, time of symptom disappearance, and the incidence of some complications rate. Large scale, multicenter, and well-designed RCTs are needed in the future to prove our conclusions.