Urinary alkalinisation for acute chlorophenoxy herbicide poisoning

October 2017

Emergency Care

Country of origin: USA

Acute poisoning with chlorophenoxy herbicides such as 2,4-D and MCPA is reported world wide, potentially causing severe toxicity and death. Since there is no antidote for chlorophenoxy herbicides, treatments such as urinary alkalinisation have been used to increase the clearance of these poisons from the body. Although urinary alkalinisation was first trialled over 30 years ago, it is not currently used routinely for the treatment of patients with acute chlorophenoxy poisoning.

This review looked for studies where this treatment had been given to poisoned patients. No studies of sufficient quality were identified and therefore routine use of this approach to treatment cannot be recommended. However, due to the poor outcomes in patients who present with severe toxicity it may have a role in addition to standard intensive care support.

The Cochrane review is available online.

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