J. Med. Toxicol. (2016) 12:3–47 DOI 10.1007/s13181-016-0538-8
ANNUAL MEETING ABSTRACTS
Abstracts from the 2016 American College of Medical Toxicology (ACMT) Annual Scientific Meeting Abstract These are the abstracts of the 2016 American College of Medical Toxicology (ACMT) Annual Scientific Meeting. Included here are 121 abstracts presented in March 2016, including research studies from around the globe and the ToxIC collaboration, clinically significant case reports describing new toxicologic phenomena, and encore presentations from other scientific meetings. Keywords Abstracts • Annual Scientific Meeting • Toxicology Investigators Consortium • Medical Toxicology Foundation • Pediatric Environmental Health Specialty Units Correspondence American College of Medical Toxicology (ACMT)10645 N. Tatum Blvd Phoenix, AZ [email protected] Introduction The ACMT received 159 eligible research abstracts for consideration for presentation at the 2016 Annual Scientific Meeting (ASM), including 92 research studies and 67 case reports. Each abstract was reviewed in a blinded fashion by at least four medical toxicologists. Each abstract was independently scored based on the clinical question, data source, analytic method, results/conclusion, and clarity of presentation. A total of 121 abstracts were accepted, for an overall acceptance rate of 76 %. The acceptance rate was 89 % for research studies, including nine “encore” research studies that were presented at other scientific meetings and deemed by the reviewers to be of high interest to the ACMT ASM participants. The acceptance rate was 56 % for case reports. This work would not be possible without the hard work and diligence of our abstract reviewers: Vik Bebarta, Katie Boyle, Diane Callelo, Stephanie Carreiro, Jonathan Cole, Kirk Cumpston, Kristin Engebretsen, Yaron Finkelstein, David Jang, Louise Kao, Ken Katz, Russ Kerns, Eric Lavonas, Michael Levine, Gerry Maloney, Andrew Monte, Mark Mycyk, Anne Riederer, Dan Rusyniak, Sam Stellpflug, Richard Wang, Brandon Willis, and Luke Yip. Even more important is the contribution of the ACMT staff. Lizzy Nguyen led the process, with significant assistance from Tara Frutkin, Tricia Steffey, and Paul Wax. Finally, we are grateful for the immense contributions of the late Jim Wiggins, who developed and refined the process for scientific abstract review since the inception of original research presentations at the ACMT Annual Scientific Meeting in 2013. We mourn the passing of an incredible colleague and a valued friend. Congratulations to all the researchers whose work will be presented in Huntington Beach. The 2016 Annual Scientific Meeting promises to be the best yet. We look forward to seeing you there. Eric Lavonas, MD, FACMT, Abstract Review Chair Russ Kerns, MD, FACMT, Chair, Research Committee Original Research: Platform Sessions 1. Randomized Controlled Study Comparing High Dose Insulin (HDI) to Vasopressors or Combination Therapy in Refractory Toxin-Induced Cardiogenic Shock (TICS) KG Katzung, JM LeRoy, SP Boley, AJ Thomas, SJ Stellpflug, JS Holger, KM Engebretsen HealthPartners Institute for Education and Research, St. Paul, MN, USA
Background: Cerebral perfusion (PBrO2) during toxic-induced cardiogenic shock (TICS) has not been formally studied. In an animal model of TICS, high dose insulin (HDI) was superior to vasopressors from a cardiovascular standpoint. However, the effects of HDI, vasopressors, or combination therapy on PBrO2 in TICS are unknown. Hypothesis: In a porcine model of refractory TICS, addition of norepinephrine (NE) after maximizing HDI therapy increases PBrO2 when compared to HDI-alone or to vasopressor (NE + Epinephrine (Epi)) therapy alone. Methods: Using an established porcine model of propranolol toxicity, 15 pigs were randomized to three groups (HDI, HDI+NE, or NE+Epi). At primary toxicity, defined as a 25 % reduction in heart rate (HR) × mean arterial pressure (MAP), HDI and HDI+NE groups were started on HDI (10 U/kg/h) and NE+Epi group started on NE (titrated to 0.5 mcg/kg/min). At secondary toxicity (PoT#2), defined as a sustained MAP
ANNUAL MEETING ABSTRACTS
Abstracts from the 2016 American College of Medical Toxicology (ACMT) Annual Scientific Meeting Abstract These are the abstracts of the 2016 American College of Medical Toxicology (ACMT) Annual Scientific Meeting. Included here are 121 abstracts presented in March 2016, including research studies from around the globe and the ToxIC collaboration, clinically significant case reports describing new toxicologic phenomena, and encore presentations from other scientific meetings. Keywords Abstracts • Annual Scientific Meeting • Toxicology Investigators Consortium • Medical Toxicology Foundation • Pediatric Environmental Health Specialty Units Correspondence American College of Medical Toxicology (ACMT)10645 N. Tatum Blvd Phoenix, AZ [email protected] Introduction The ACMT received 159 eligible research abstracts for consideration for presentation at the 2016 Annual Scientific Meeting (ASM), including 92 research studies and 67 case reports. Each abstract was reviewed in a blinded fashion by at least four medical toxicologists. Each abstract was independently scored based on the clinical question, data source, analytic method, results/conclusion, and clarity of presentation. A total of 121 abstracts were accepted, for an overall acceptance rate of 76 %. The acceptance rate was 89 % for research studies, including nine “encore” research studies that were presented at other scientific meetings and deemed by the reviewers to be of high interest to the ACMT ASM participants. The acceptance rate was 56 % for case reports. This work would not be possible without the hard work and diligence of our abstract reviewers: Vik Bebarta, Katie Boyle, Diane Callelo, Stephanie Carreiro, Jonathan Cole, Kirk Cumpston, Kristin Engebretsen, Yaron Finkelstein, David Jang, Louise Kao, Ken Katz, Russ Kerns, Eric Lavonas, Michael Levine, Gerry Maloney, Andrew Monte, Mark Mycyk, Anne Riederer, Dan Rusyniak, Sam Stellpflug, Richard Wang, Brandon Willis, and Luke Yip. Even more important is the contribution of the ACMT staff. Lizzy Nguyen led the process, with significant assistance from Tara Frutkin, Tricia Steffey, and Paul Wax. Finally, we are grateful for the immense contributions of the late Jim Wiggins, who developed and refined the process for scientific abstract review since the inception of original research presentations at the ACMT Annual Scientific Meeting in 2013. We mourn the passing of an incredible colleague and a valued friend. Congratulations to all the researchers whose work will be presented in Huntington Beach. The 2016 Annual Scientific Meeting promises to be the best yet. We look forward to seeing you there. Eric Lavonas, MD, FACMT, Abstract Review Chair Russ Kerns, MD, FACMT, Chair, Research Committee Original Research: Platform Sessions 1. Randomized Controlled Study Comparing High Dose Insulin (HDI) to Vasopressors or Combination Therapy in Refractory Toxin-Induced Cardiogenic Shock (TICS) KG Katzung, JM LeRoy, SP Boley, AJ Thomas, SJ Stellpflug, JS Holger, KM Engebretsen HealthPartners Institute for Education and Research, St. Paul, MN, USA
Background: Cerebral perfusion (PBrO2) during toxic-induced cardiogenic shock (TICS) has not been formally studied. In an animal model of TICS, high dose insulin (HDI) was superior to vasopressors from a cardiovascular standpoint. However, the effects of HDI, vasopressors, or combination therapy on PBrO2 in TICS are unknown. Hypothesis: In a porcine model of refractory TICS, addition of norepinephrine (NE) after maximizing HDI therapy increases PBrO2 when compared to HDI-alone or to vasopressor (NE + Epinephrine (Epi)) therapy alone. Methods: Using an established porcine model of propranolol toxicity, 15 pigs were randomized to three groups (HDI, HDI+NE, or NE+Epi). At primary toxicity, defined as a 25 % reduction in heart rate (HR) × mean arterial pressure (MAP), HDI and HDI+NE groups were started on HDI (10 U/kg/h) and NE+Epi group started on NE (titrated to 0.5 mcg/kg/min). At secondary toxicity (PoT#2), defined as a sustained MAP
