A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

Abstract

Background: Organophosphate (OP) compounds are used as insecticides. Given the widespread availability and use of these chemicals, OP poisoning is quite common following either accidental or intentional exposures. Immediate intensive care management can save lives in these patients. We aimed to investigate intensive care management provided to OP poisoning patients in a tertiary care hospital in Turkey. Subjects and Methods: This was a retrospective chart review of 62 patients, admitted to the Intensive Care Unit (ICU) with OP poisoning between 2000 and 2012. Results: Of the 62 patients studied, 40 (65%) were male, 45 (73%) were suicide attempts, 59 (95%) ingested the OP compounds, and three patients (5%) (two patients with suicide and 1 with accidental exposure) died in the ICU. There were statistically significant differences between survivors and nonsurvivors for Glasgow Coma Scale (GCS) on admission (P = 0.034), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (P = 0.003), Sequential Organ Failure Assessment (SOFA) score (P = 0.024), time to initiation of treatment (P = 0.034) and serum lactate dehydrogenase (LDH) levels (P = 0.007). Conclusions: Organophosphate poisoning is a life-threatening condition that requires immediate diagnosis and management. GCS, APACHE II score, SOFA score, and time to admission to the emergency department and LDH levels can provide prognostic information and predict outcomes.

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

“…3,37,38 This might be explained by the fact that atropine was prescribed in a very low dose for a short time with oxime therapy not prescribed to all patients and inadequate supportive care. Studies conducted after the year of 2000 have consistently shown mortality rates below 15%.…”

“…Studies conducted after the year of 2000 have consistently shown mortality rates below 15%. 37,39 This can be explained by universal provision of continuous high dose atropine, consistent use of pralidoxime and better access to supportive therapy such as ICU care, ventilator support and respiratory therapy etc. In our study, the mortality was 17.34% (56 of the 323 cases) and 124 (38.41%) patients had to be ventilated.…”

Sudden bilateral hearing loss after organophosphate inhalation

“…OP poisoning commonly occurs following ingestion, inhalation, and absorption of OP compounds4, 5 The most common mechanism of ototoxicity associated with OP poisoning is production of reactive oxygen species (ROS) 6 . OPs also affect acetylcholinesterase, whose function is to hydrolyze acetylcholine that most important neurotransmitter in the central and peripheral nervous systems 1, 2, 5…”

Fresh Red Blood Transfusion as a Successful Erythrocyte Cholinesterase Supplement in Organophosphate Poisoning

“…Diagnosis of OP poisoning was based on information taken either from the patient or their family about the agent involved in the exposure. We confirmed the diagnosis of OP poisoning by measuring plasma cholinesterase (ChE) levels [8]. ChE levels were determined using an Olympus U2700 spectrophotometric chemistry analyzer (Beckman Coulter, Tokyo, Japan).…”