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

Background: 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. method: 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. results: 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). conclusion: 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.