Intravenous lipid emulsion infusion in acute intoxication with fenitrothion

Abstract

Organophosphorus pesticides (OPs) are widely used in agriculture as insecticides, fungicides and rodenticides. They have a specific unpleasant odor. Due to their widespread use and high lethality, intoxications with them are a global problem (1,2). More than 200,000 people die each year after poisoning with OPs (3). Patients with acute organophosphorus intoxications require immediate treatment to prevent complications and lethal outcome. Despite the con-ABSTRACT Acute intoxications with organophosphorus pesticides (OPs) are a challenge for the clinical toxicology, because they are common, severe and with high lethality. Most OPs are lipophilic. In recent years, intravenous lipid emulsion (ILE) has been successfully used to treat acute poisoning with lipophilic xenobiotics. A clinical case of a 64-year-old male hospitalized after oral intake of 50 ml of fenitrothion is reported. He had been hospitalized with tachypnea and depressed consciousness-8 by Glasgow Coma Scale (GCS). Treatment standardized for this type of intoxication was initiated. On the 3rd hour treatment with Intralipid 20% was started, with a bolus dose of 1.5 ml/kg followed by infusion at a rate of 0.25 ml/kg/min to a total dose of 1000 ml. At the 16th hour consciousness was restored to GCS-15. In severe OPs intoxications ILE can be used as an additional method of controlling cardiotoxic and neurotoxic effects.

Lipid emulsions in the treatment of acute poisoning in the Clinic of Toxicology at the Naval Hospital-Varna, Military Medical Academy-Sofia

“…In Bulgaria, LEs are not yet the first-line treatment in lipophilic drug intoxications. Shmilev (6), Marinov (7,8,9) and Zlateva (10) report on their treatment options. In Bulgaria there are no studies to prove the cardioprotective effect of LE on both experimental animals and humans.…”