Phase II study of magnesium sulfate in acute organophosphate pesticide poisoning

Basher, Ariful; Rahman, S. H.; Ghose, Aniruddha; Arif, SM; Faiz, Mohammad Abul; Dawson, Andrew

doi:10.3109/15563650.2012.757318

Cited by 34 publications

(28 citation statements)

References 24 publications

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“…MgSO 4 at all doses was well-tolerated. [20] However, a dose of 4 g was selected for this study, keeping in mind the ease of administration and need for less intense monitoring of magnesium levels. Although an increase in serum magnesium levels was noted following the administration of MgSO 4 , it was within the therapeutic range, and none of the patients had clinical side effects attributable to magnesium.…”

Section: Discussionmentioning

confidence: 99%

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Study of effect of magnesium sulphate in management of acute organophosphorous pesticide poisoning

et al. 2017

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Background:Organophosphorus compound poisoning (OPCP) is a major public health problem in developing countries like India. Atropine and oximes remain the main-stay of management. Magnesium sulfate (MgSO4) has shown benefit in the management of OPCP.Aims:This study was designed to assess the effect of MgSO4 on outcome in OPCP patients admitted to Intensive Care Unit (ICU).Settings and Design:Double-blind prospective randomized clinical trial in an ICU of tertiary care institution.Methods:One hundred patients (50 in each group) of OPCP, confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged between 18 and 60 years were studied. Magnesium group (Group M) received 4 g of 20% MgSO4 infusion over 30 min at admission to ICU, control group (Group C) received normal saline placebo in the same manner. Patients were assessed for the need for intubation, requirement of atropine, duration of mechanical ventilation, duration of ICU stay, and its effect on mortality.Statistical Analysis:Chi-square test and Fisher's exact test for categorical data, independent sample t-test, and paired t-test for nominal data.Results:Demographics and basal serum magnesium levels were comparable. Atropine requirement was higher in Group C (74.82 ± 22.39 mg) compared to Group M (53.11 ± 45.83 mg) (P < 0.001). A total of 33 patients in Group C and 23 patients in Group M required intubation, respectively (P = 0.043). The mean duration of mechanical ventilation was 4.51 ± 2 days in Group C compared to 4.13 ± 1.6 days in Group M (P = 0.45). ICU stay was 5.36 ± 2.018 days in Group C compared to 4.54 ± 1.581 days in Group M (P = 0.026). There was no significant difference in mortality between the groups.Conclusion:Four grams of MgSO4 given to OPCP patients within 24 h of admission to ICU, decreases atropine requirement, need for intubation, and ICU stay.

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Section: Discussionmentioning

confidence: 99%

“…The observations concur with that of other studies. [1920] The requirement of atropine in OPCP may vary with the severity of poisoning. [21] There is conflicting evidence regarding the effect of magnesium on atropine requirement.…”

Section: Discussionmentioning

confidence: 99%

Study of effect of magnesium sulphate in management of acute organophosphorous pesticide poisoning

et al. 2017

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“…Sodium bicarbonate, magnesium, and diazepam are used in human OP insecticide poisonings but have not shown overall benefit (107,111). Improved airway control during hospital transfer, by intubation or placement of supraglottic airways, could reduce pulmonary complications.…”

Section: Hours To Daysmentioning

confidence: 99%

Respiratory Complications of Organophosphorus Nerve Agent and Insecticide Poisoning. Implications for Respiratory and Critical Care

Hulse

Davies

Simpson

et al. 2014

Am J Respir Crit Care Med

151

104

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Organophosphorus (OP) compound poisoning is a major global public health problem. Acute OP insecticide self-poisoning kills over 200,000 people every year, the majority from self-harm in rural Asia. Highly toxic OP nerve agents (e.g., sarin) are a significant current terrorist threat, as shown by attacks in Damascus during 2013. These anticholinesterase compounds are classically considered to cause an acute cholinergic syndrome with decreased consciousness, respiratory failure, and, in the case of insecticides, a delayed intermediate syndrome that requires prolonged ventilation. Acute respiratory failure, by central and peripheral mechanisms, is the primary cause of death in most cases. However, preclinical and clinical research over the last two decades has indicated a more complex picture of respiratory complications after OP insecticide poisoning, including onset of delayed neuromuscular junction dysfunction during the cholinergic syndrome, aspiration causing pneumonia and acute respiratory distress syndrome, and the involvement of solvents in OP toxicity. The treatment of OP poisoning has not changed over the last 50 years. However, a better understanding of the multiple respiratory complications of OP poisoning offers additional therapeutic opportunities.

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“…Larger controlled studies should be performed to determine the efficacy of magnesium sulphate in OP poisoning. (21) LIMITATION Limitations of our study are small sample size and a further potential limitation is that we did not have the capacity to confirm exposure by analysis and identification of the specific organophosphate or by inhibition of cholinesterase. However, cohort studies in similar settings showed laboratory confirmation of agrochemicals ingestion in 95% of cases.…”

Section: Discussionmentioning

confidence: 99%

A Case Control Study of Intravenous Magnesium Sulphate in Treatment of Acute Organophosphate Poisoning

Philomena¹,

Sathi²,

Parthasarathy³

2016

jemds

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Phase II study of magnesium sulfate in acute organophosphate pesticide poisoning

Abstract: Magnesium was well tolerated in this study. Larger studies are required to examine for efficacy.

Cited by 34 publications

References 24 publications

Study of effect of magnesium sulphate in management of acute organophosphorous pesticide poisoning

Study of effect of magnesium sulphate in management of acute organophosphorous pesticide poisoning

Respiratory Complications of Organophosphorus Nerve Agent and Insecticide Poisoning. Implications for Respiratory and Critical Care

A Case Control Study of Intravenous Magnesium Sulphate in Treatment of Acute Organophosphate Poisoning

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