The early prognostic factors of glyphosate-surfactant intoxication

Lee, Ching-Hsing; Shih, Chia-Pang; Hsu, Kuang‐Hung; Hung, Dong-Zong; Lin, Chun‐Yen

doi:10.1016/j.ajem.2007.05.011

Cited by 73 publications

(69 citation statements)

References 12 publications

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“…The case fatality rates were around 1.9 to 16 % (Sawada et al, 1988;Tominack et al, 1991;Talbot et al, 1991;Hung et al, 1997;Lee, et al, 2000;Suh et al, 2007), and a large study by the Poison Control Center (PCC) of Taiwan, which included 2186 cases of GlySH poisoning from 1986-2007, reported a case fatality rate of 7.2% (Chen et al, 2009). However, a much higher fatality rate up to 29.3% has been found in a recent study (Lee et al, 2008). Obviously, it continues to be a public health problem that calls for concerns.…”

Section: Epidemiology Of Glyphosate Poisoning In Taiwan and Other Coumentioning

confidence: 97%

“…The main surfactant used in GlySH products worldwide is polyoxyethyleneamine (CAS Number 61791-26-2). GlySH, an alternative to paraquat, has been used in suicide attempts in Taiwan and many countries in the Asia-Pacific region (Sawada et al, 1988;Menkes et al, 1991;Tominack et al, 1991;Talbot et al, 1991;Hung et al, 1997;Lee et al, 2000;Stella and Ryan, 2004;van der and Konradsen, 2006;Lee et al, 2008;Roberts et al, 2010). The case fatality rates were around 1.9 to 16 % (Sawada et al, 1988;Tominack et al, 1991;Talbot et al, 1991;Hung et al, 1997;Lee, et al, 2000;Suh et al, 2007), and a large study by the Poison Control Center (PCC) of Taiwan, which included 2186 cases of GlySH poisoning from 1986-2007, reported a case fatality rate of 7.2% (Chen et al, 2009).…”

Section: Epidemiology Of Glyphosate Poisoning In Taiwan and Other Coumentioning

confidence: 99%

“…The risk factors of fatality or severity of GlySH exposure have been studied and discussed over the years, including the amount of exposure, hypovolemic shock, intractable shock, Acute Physiology and Chronic Health Evaluation II score, age, male gender, laryngeal injury with aspiration, abnormal chest X-ray, calendar time, reason for exposure, atropine therapy, elapsed time, delayed presentation, number of involved organs, metabolic acidosis, tachycardia, elevated serum creatinine, and high plasma glyphosate concentrations on admission (> 734 ug/mL) (Sawada et al, 1988;Tominack et al, 1991;Talbot et al, 1991;Hung et al, 1997;Lee et al, 2000;Lee et al, 2008;Chen et al, 2009;Roberts et al, 2010). Prognostic predictors can help emergency staff in identifying patients who are expected to deteriorate or die.…”

Section: Predictors Of Glysh Poisoningmentioning

confidence: 99%

See 2 more Smart Citations

The Hemodynamic Effects of the Formulation of Glyphosate-Surfactant Herbicides

Lee¹,

Guo²

2011

Herbicides, Theory and Applications

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Section: Epidemiology Of Glyphosate Poisoning In Taiwan and Other Coumentioning

confidence: 97%

Section: Epidemiology Of Glyphosate Poisoning In Taiwan and Other Coumentioning

confidence: 99%

Section: Predictors Of Glysh Poisoningmentioning

confidence: 99%

See 1 more Smart Citation

The Hemodynamic Effects of the Formulation of Glyphosate-Surfactant Herbicides

Lee¹,

Guo²

2011

Herbicides, Theory and Applications

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“…This is because ingestion was witnessed by bystanders, there was no evidence that any other substance had been taken, and the clinical course was typical of other similar cases described in the literature. [7][8][9][10][11][12]15,17,20,22,23 It is not beyond the realms of possibility however, for another substance to have affected the patient' s clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…6 There are now a number of (mostly Asian) studies in the literature, reporting the clinical features of GlySH intoxication. [7][8][9][10][11][12] These include from 58 to 2,186 patients, and the reported case fatality rate is between 3.2% and 29.3%. Clinical features common to most fatal cases of GlySH toxicity found in these studies were:…”

Section: Discussionmentioning

confidence: 99%

Fatal Poisoning with Glyphosate-Surfactant Herbicide

Beswick

Millo

2011

Journal of the Intensive Care Society

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A 29-year-old man was admitted following the deliberate (witnessed) ingestion of approximately 300 mL of 'Roundup Ace,' a herbicide containing glyphosate as its active ingredient. On presentation he was agitated and sweating, with partial airway obstruction and trismus. He required intubation and mechanical ventilation for airway control.Initial blood gases were normal but within a few hours of admission he had developed a severe and persistent lactic acidosis. A continuous sodium bicarbonate infusion was commenced in an attempt to reverse this. Hyperkalaemia developed rapidly, and was associated with cardiac arrhythmias including ventricular tachycardia. Hyperkalaemia was initially managed with intravenous calcium gluconate and insulin and dextrose, while a haemofiltration catheter was inserted. Seven hours after admission, the patient was started on continuous veno-venous haemofiltration (CVVHF), which two hours later was changed to haemodiafiltration (CVVHDF) following telephone advice from the National Poisons Information Service. CVVHDF was maintained almost continuously, at a dose of 35 mL/kg/h, for around 40 hours of his 59-hour admission to the critical care unit. Accusol 35 (Baxter International Inc.) was used as the buffer solution.Hypotension became a persistent problem, and by hour 10 of his admission, a noradrenaline infusion was commenced at a rate of 0.543 µg/kg/min. Despite the patient receiving approximately 10 litres of intravenous fluid on the first day of admission alone, and maintaining a mean central venous pressure of around 12.5 cm H 2 O, he was requiring up to 1.43 µg/kg/min of noradrenaline by day 2. Although oesophageal Doppler haemodynamic monitoring was available on the unit it was not used. This was due to fears that the patient was at increased risk of oesophageal perforation, secondary to the corrosive effects of GlySH.Approximately 12 hours after admission, the patient developed torrential watery diarrhoea and a distended abdomen. Serum pH was maintained within a relatively normal range but lactataemia persisted despite CVVHDF (Figure 1). Therefore, when more stable on day 2, CVVHDF was interrupted and the patient had a CT scan of his abdomen to rule out an intra-abdominal cause for the high lactate. The CT revealed an ileus and otherwise apparently normal internal organs. The patient also had an upper GI endoscopy due to concerns that the GlySH ingestion may have caused a stenosed or perforated oesophagus. His oesophagus was ulcerated, though patent, and he had extensive oesophago-gastritis.After returning from the CT scanner and before restarting haemofiltration, the patient suffered a cardiac arrest. Return of spontaneous circulation occurred with cardiopulmonary resuscitation (CPR) and a single synchronised DC shock for ventricular tachycardia. He was placed back on CVVHDF and a transthoracic echocardiogram revealed no structural cardiac Fatal poisoning with glyphosatesurfactant herbicide E Beswick, J MilloA 29-year-old man was admitted following deliberate ingestion of appro...

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