In Acute Organophosphate Poisoning, the Efficacy of Hemoperfusion on Clinical Status and Mortality

Abstract

The aims of this study were to report experience in patients with organophosphate poisoning (OPP) and to discuss the potential role for hemoperfusion (HP) in the management of severe OPP. At the emergency service of a university hospital, 52 patients with acute OPP were included in this retrospective study. The patients were divided into 2 groups (Group 1, severe poisoning, n = 25; and Group 2, mild poisoning, n = 27). All patients with mild OPP survived. Seven patients (28%) of the 25 with severe OPP died. This study supports previous data documenting that HP is unnecessary in the management of mild OPP. Although there was not a control group (severe poisoning without HP treatment) in this study, experience suggests that HP can be useful in severe cases. Reports from centers having experience with severe OPP can help clarify this controversial issue. Randomized controlled (prospective) studies investigating the possible beneficial effects of HP on patient survival in patients with severe OPP with control group are needed.

Advances in the management of organophosphate poisoning

“…Two meta-analyses [5,28] , as well as two systematic reviews [6,29] and a Cochrane review [30] evaluating the role of oximes in OP poisoning were also identified. In addition, one prospective trial each on magnesium [31] and fresh frosen plasma therapy [32] , two trials on haemoperfusion [33,34] , as well as a Cochrane systematic review on the role of alkalinisation in human OP poisoning [35] were identified. The physiological basis of each of these therapies as available from animal and experimental data was also reviewed.…”

“…Although Peng et al [34] , in the prospective evaluation, demonstrated benefits with haemoperfusion, Altintop et al . [33] found more deaths in a retrospective cohort that underwent haemoperfusion. However, the crucial factor determining response, again as with oximes, may be the time of provision of haemoperfusion.…”

“…Two recent publications presented data on the role of haemoperfusion in acute OP poisoning [33,34] ( Table 3 ). In a retrospective report of 52 OP poisoned patients from Turkey, 25 patients with severe poisoning treated with haemoperfusion were compared with 27 patients with mild poisoning not receiving haemoperfusion [33] .…”

“…In a retrospective report of 52 OP poisoned patients from Turkey, 25 patients with severe poisoning treated with haemoperfusion were compared with 27 patients with mild poisoning not receiving haemoperfusion [33] . Seven patients with severe poisoning died; all in the haemoperfusion group.…”

Organophosphate Poisoning Due to a Wheat Bagel

“…As reported in the literature (2,5,20,21) It is described in literature that OP poisoning is an important cause of mortality and morbidity (6,23,24). Yurumez et al (17) and Seydaoglu (21) It is said that necrotizing pancreatitis (25), coital-like involuntary movements (26) and intermediary syndrome may develop in patients after OP poisoning (27,28).…”