Comparison of the palatabilities of standard and superactivated charcoal in toxic ingestions: A randomized trial

Abstract

Objective: To compare the palatabilities of two activated charcoal formulations in patients with potentially toxic ingestions. Methods: Prospective double-blinded randomized controlled trial comparing the palatability of standard charcoal [LiquiChar (LC)] with that of a superactivated granulated form [(CharcoAid G (CA)]. Alert adult patients with known or suspected toxic ingestions requiring activated charcoal were randomly assigned to receive 60 g of either LC or CA diluted in a cola beverage to a volume of 340 mL. Standardized forms were used to collect data on patient demographics, time required to drink the charcoal, the remaining volume of activated charcoal, and any adverse reactions. Patients rated the palatability of the activated charcoal on a 100-mm visual analog scale (VAS) with 100 indicating 'best imaginable beverage.' Telephone follow-up was obtained to identify complications. Student's t-tests or Mann-Whitney U tests were used to compare continuous variables (e.g., VAS, time, age). Fisher's exact tests were used to compare categorical variables. This study had a power of 0.9 to detect a 20-mm difference in the VAS, alpha = 0.05. Results: There were 60 patients enrolled; 29 drank LC, 31 drank CA. Mean age was 34 years; 68% were female. The groups were similar for age, time from ingestion, ingested agents, time required to drink charcoal, and remaining volume. There were more females in the LC group. Patients receiving CA had significantly higher palatability scores than those receiving LC [35.9 (95% CI = 22.5 to 49.3 mm) vs 19.0 mm (95% CI = 9.3 to 28.6 mm) p = 0.04]. None of the patients aspirated. Of seven patients who vomited, five were given LC (p = 0.25). Conclusions: CharcoAid is more palatable to patients with toxic ingestions than the standard nongranulated form. Use of the granular charcoal may improve patient compliance.