Therapeutic properties of haemodialysis and blood exchange transfusion in organophosphate poisoning

Okonek, S.; Boelcke, G; Hollmann, H.

doi:10.1007/bf00571891

Cited by 13 publications

(5 citation statements)

References 18 publications

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“…Thus, RRT may be considered in cases of overdose or intoxication with certain alcohols (for example, methanol, ethylene glycol), salicylate, lithium, theophylline or methotrexate [84]. Extended dialysis has also been described as being successful in paraquat intoxication, although haemoperfusion appears more effective [85]. …”

Section: Non-'renal' Indications For Renal Replacement Therapymentioning

confidence: 99%

Clinical review: Timing of renal replacement therapy

Joannidis

Forni

2011

Crit Care

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Acute kidney injury is common in intensive care patients and continuous renal replacement therapy is the preferred treatment for this in most centres. Although these techniques have been adopted internationally, there remains significant variation with regard to their clinical application. This is particularly pertinent when one considers that the fundamental questions regarding any treatment, such as initiation, dose and length of treatment, remain a source of debate and have not as yet all been fully answered. In this narrative review we consider the timing of renal replacement therapy, highlighting the relative paucity of high quality data regarding this fundamental question. We examine the role of the usual biochemical criteria as well as conventional clinical indications for commencing renal replacement therapy together with the application of recent classification systems, namely RIFLE and AKIN. We discuss the potential role of biomarkers for acute kidney injury as predictors for the need for renal support and discuss commencing therapy for indications other than acute kidney injury.

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Section: Non-'renal' Indications For Renal Replacement Therapymentioning

confidence: 99%

Clinical review: Timing of renal replacement therapy

Joannidis

Forni

2011

Crit Care

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“…With compounds such as fenthion and analogues, recurrent cholinergic crises have been observed (5-9, 14, 15). Other compounds involved in similar cases include Bidrin (16), diazinon (17), and dimethoate (19,20). Apart from intermittent muscarinic manifestations, persistent weakness of respiratory, proximal limb, external ocular, facial, palatal and nuchal muscles, and hyporeflexia have been noted in some of these cases.…”

Section: Discussionmentioning

confidence: 99%

“…Low esterase values were observed for as long as the IMS persisted, presumably because of delayed hepatic metabolism and/or impaired urinary excretion of parathion or its active metabolite. Hemodialysis has proven insufficient to remove significant amounts of parathion or paraoxon (20,21). It can be hypothesized that the IMS is due to long-term esterase inhibition, and is not primarily compound-specific.…”

Section: Discussionmentioning

confidence: 99%

Intermediate syndrome due to prolonged parathion poisoning

Bleecker

Vogelaers

Ceuterick³

et al. 1992

Acta Neurologica Scandinavica

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A parathion-poisoned patient with prolonged cholinesterase inhibition due to impaired hepatic metabolism and urinary excretion is reported. An intermediate syndrome characterized by respiratory paresis, weakness in the territory of several motor cranial nerves and of proximal limb and neck flexor muscles, persisted for 3 weeks. During this whole period, cholinesterase remained markedly reduced. Serial EMGs with repetitive nerve stimulation pointed to a combined pre- and postsynaptic disorder of neuromuscular transmission. Electron microscopy of an intercostal muscle biopsy showed focal degeneration at the poorly branched postsynaptic folds, and was considered to be nonspecific.

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“…reported the change in total activity of AChE in the blood in parathion‐poisoned rats upon blood‐exchange transfusion. Indeed, the AChE level was recovered from ∼10% to >50% after exchange transfusion of 6.7 mL of blood per 100 g body weight …”

Section: Exogenous Achementioning

confidence: 99%

Efforts toward treatments against aging of organophosphorus‐inhibited acetylcholinesterase

Zhuang

Young

Callam

et al. 2016

Annals of the New York Academy of Sciences

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Aging is a dealkylation reaction of organophosphorus (OP)-inhibited acetylcholinesterase (AChE). Despite many studies to date, aged AChE cannot be reactivated directly by traditional pyridinium oximes. This review summarizes strategies that are potentially valuable in the treatment against aging in OP poisoning. Among them, retardation of aging seeks to lower the rate of aging through the use of AChE effectors. These drugs should be administered before AChE is completely aged. For postaging treatment, realkylation of aged AChE by appropriate alkylators may pave the way for oxime treatment by neutralizing the oxyanion at the active site of aged AChE. The other two strategies, upregulation of AChE expression and introduction of exogenous AChE, cannot resurrect aged AChE but may compensate for lowered active AChE levels by in situ production or external introduction of active AChE. Upregulation of AChE expression can be triggered by some peptides. Sources of exogenous AChE can be whole blood or purified AChE, either from human or nonhuman species.

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Therapeutic properties of haemodialysis and blood exchange transfusion in organophosphate poisoning

Cited by 13 publications

References 18 publications

Clinical review: Timing of renal replacement therapy

Clinical review: Timing of renal replacement therapy

Intermediate syndrome due to prolonged parathion poisoning

Efforts toward treatments against aging of organophosphorus‐inhibited acetylcholinesterase

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