Epidemiology and Treatment of Severe Poisoning in the Intensive Care Unit: Lessons from a One-Year Prospective Observational Study

Mehrpour, Omid

doi:10.4172/2161-0495.s1-007

Cited by 7 publications

(10 citation statements)

References 28 publications

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“…This is comparable with the findings of previous studies; Singh et al (2011) found that 50.7% of the studied cases were males and from age group 21 to 30 years in a study done in a tertiary care hospital in the metropolitan city of New Delhi. Taghaddosinejad et al (2012) showed that the majority of the studied patients were young (below 30 years); males (57%) and either employed (40.2%), students or housewives.…”

Section: Discussionmentioning

confidence: 91%

“…However, in Iran (Baharloo Hospital, Tehran. ), life-threatening poisoned patients requiring ICU admission constituted 8% of the total poisoned cases admitted during one year (Taghaddosinejad et al, 2012). Arıkan et al (2014) found that acute intoxications constituted 7.61% of the admitted patients to ICU of Karabük Training and Research Hospital in Turkey.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to the present study, Azab (2009) reported that, 41.1% of the studied patients received pre hospital treatment and gastric lavage was done to 42% of the studied cases. Taghaddosinejad et al (2012) found that gastric lavage was done to 88% of admitted patients to ICU. The present finding is strange as all patients came after one hour of poison administration.…”

Section: Discussionmentioning

confidence: 99%

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Prediction of Outcome of Acutely Intoxicated Patients Admitted To Intensive Care Unit in Mansoura-Dakhlia Governorate-Egypt

Oreby

Maklad

Shihab

et al. 2016

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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Acute poisoning is a frequent cause of admission to emergency departments and intensive care units, as it is considered as an important medical emergency requiring early diagnosis and rapid initiation of therapy. The aim of the present study was to assess characteristics, and outcomes of acutely intoxicated patients who were admitted to ICU. Also, design a scoring system regarding priority for ICU admission. The present study was carried out on 40 patients who were admitted to intensive care unit of El Mansoura General Hospitals-Egypt during a period of 6 months. Personal, toxicological, and medical histories, clinical examination and routine investigations were recorded for each patient. At discharge; all patients were reassessed for determination of patients' outcome. The patients were mostly females, single; student aged less than 30 years and from rural areas. The majority of the patients (72.5%) were recovered, 22.5% were died and 5% were referred to hyperbaric oxygen therapy units after carbon monoxide intoxication. Many patients were presented by constricted pupil (45%), respiratory depression (42.5%), altered mental status (42.5%), tachycardia (47.5%), and nausea & vomiting (75%). The highest numbers of cases were poisoned by medicinal drugs (40%) followed by agricultural chemicals (35%). Statistically significant difference between occupation, toxicological amount & frequency, pulse rate, Glasgow coma score, PH & PCO2 and type of poison (zinc phosphide) and patient outcomes was observed. Although many of the patients' characteristics were significantly associated with patient outcome yet none of them was considered significant predictors for death. So, the suggested scoring system depended mainly on clinical data and simple rapid investigation that may be helpful for rapid assessment of the patients after further validation. We recommend the presence of a channel of communication between the general care centers and the poison control centers for consultation about the protocol of treatment of poisoned patients. Nationwide, a mechanism of communication between the poison centers must be done to benefit from the different expertise and to make a uniform protocol for treatment of poisoned cases to decrease the mortality rate and the burden on hospitals resources.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prediction of Outcome of Acutely Intoxicated Patients Admitted To Intensive Care Unit in Mansoura-Dakhlia Governorate-Egypt

Oreby

Maklad

Shihab

et al. 2016

Ain Shams Journal of Forensic Medicine and Clinical Toxicology

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“…About 10% of the 80 million total Iranian population are living in Tehran and these two main referral centres serve 10% of the population of the country 19 , 25 . We therefore estimate that 42 940 patients in the country were possibly treated for lead poisoning, of whom nearly 20 000 received lead-chelating agents (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Lead poisoning outbreak among opium users in the Islamic Republic of Iran, 2016–2017

Ghane

Zamani

Hassanian‐Moghaddam

et al. 2018

Bull. World Health Organ.

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ObjectiveTo describe an outbreak of lead poisoning among opium users in the Islamic Republic of Iran and estimate the number of affected people in the country.MethodsWe used data from the country’s largest poison treatment centre to illustrate the epidemiology of an outbreak of lead poisoning in oral opium users. We describe the government’s referral and treatment guidelines in response to the outbreak. Based on the number of individuals treated and previous studies on the prevalence of oral opium use we estimated the total number of people at risk of lead-contaminated opium nationwide.FindingsIn February 2016, we noticed a steep increase in the numbers of oral opium users referred to our poison treatment centre with abdominal pain, anaemia and constipation. Numbers peaked in June 2016 but the outbreak was ongoing in August 2017. The mean blood lead level in a sample of 80 patients was 140.3 µg/dL (standard deviation: 122.6). Analysis of an illegal opium sample showed 3.55 mg lead in 1 g opium. Treatment was exposure reduction with opioid substitutes and laxatives, or chelation therapy if indicated. Over 7 months, 4294 poison cases were seen at main referral hospitals in Tehran out of an estimated 31 914 oral opium users in the city. We estimate more than 260 000 out of 773 800 users nationwide remain untreated and at risk of poisoning.ConclusionLead-contaminated opium and heroin that has transited through the Iranian markets is a global risk and highlights a need for better monitoring of illegal drug supplies.

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“…Poisoning with fatal agents such as aluminum phosphide, paraquat, organophosphate, or massive pharmaceutical drug overdoses usually needs ICU care and sometimes mechanical ventilation [5,6]. A question is therefore arisen: which of these agents is better to be used for ulcer prophylaxis in poisoned patients?…”

Section: Letter To the Editormentioning

confidence: 99%

Stress ulcer prophylaxis in critically ill poisoned patients

2012

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Epidemiology and Treatment of Severe Poisoning in the Intensive Care Unit: Lessons from a One-Year Prospective Observational Study

Abstract: Background: Acute poisoning is a frequent cause of admission to emergency departments (ED) and often requires treatment in the intensive care unit (ICU). The objective of this study is to characterize the patients admitted to an ICU in a toxicology referral center in Iran.

Cited by 7 publications

References 28 publications

Prediction of Outcome of Acutely Intoxicated Patients Admitted To Intensive Care Unit in Mansoura-Dakhlia Governorate-Egypt

Prediction of Outcome of Acutely Intoxicated Patients Admitted To Intensive Care Unit in Mansoura-Dakhlia Governorate-Egypt

Lead poisoning outbreak among opium users in the Islamic Republic of Iran, 2016–2017

Stress ulcer prophylaxis in critically ill poisoned patients

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