Prognostic value of serial serum cholinesterase activities in organophosphate poisoned patients

Chen, Hsien-Yi; Wang, Warren Wei-Jen; Chaou, Chung-Hsien; Lin, Chih-Chuan

doi:10.1016/j.ajem.2008.07.006

Cited by 18 publications

(20 citation statements)

References 14 publications

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“…[3,26] Chen et al found that the absence of rising PCE levels in the 48 h after treatment of OP poisoning was associated with a higher mortality rate. [27] Another study conducted by Tsai et al found no significant association between the severity of OP poisoning and serum AChE levels. [28] A study conducted by Manu et al found that serial measurements of serum AChE levels may help predict the length of ICU stay, duration on mechanical ventilation and the prognosis of the patient following OP poisoning.…”

Section: Discussionmentioning

confidence: 95%

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

et al. 2015

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Background: Organophosphate (OP) compounds are used as insecticides. Given the widespread availability and use of these chemicals, OP poisoning is quite common following either accidental or intentional exposures. Immediate intensive care management can save lives in these patients. We aimed to investigate intensive care management provided to OP poisoning patients in a tertiary care hospital in Turkey. Subjects and Methods: This was a retrospective chart review of 62 patients, admitted to the Intensive Care Unit (ICU) with OP poisoning between 2000 and 2012. Results: Of the 62 patients studied, 40 (65%) were male, 45 (73%) were suicide attempts, 59 (95%) ingested the OP compounds, and three patients (5%) (two patients with suicide and 1 with accidental exposure) died in the ICU. There were statistically significant differences between survivors and nonsurvivors for Glasgow Coma Scale (GCS) on admission (P = 0.034), Acute Physiology and Chronic Health Evaluation II (APACHE II) score (P = 0.003), Sequential Organ Failure Assessment (SOFA) score (P = 0.024), time to initiation of treatment (P = 0.034) and serum lactate dehydrogenase (LDH) levels (P = 0.007). Conclusions: Organophosphate poisoning is a life-threatening condition that requires immediate diagnosis and management. GCS, APACHE II score, SOFA score, and time to admission to the emergency department and LDH levels can provide prognostic information and predict outcomes.

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Section: Discussionmentioning

confidence: 95%

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

et al. 2015

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“…According to the available literature, the acute physiology and chronic health evaluation II (APACHE II) score and serial cholinesterase changes are two OP poisoning severity assessment tools [15] , [16] , [17] . Higher mortality rates were observed among those with higher APACHE II scores in previous studies [15] , [16] .…”

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confidence: 99%

The effectiveness of patient-tailored treatment for acute organophosphate poisoning

et al. 2016

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BackgroundTo determine a new pralidoxime (PAM) treatment guideline based on the severity of acute organophosphate intoxication patients, APACHE II score, and dynamic changes in serum butyrylcholinesterase (BuChE) activity.MethodsThis is a randomization trial. All patients received supportive care measurements and atropinization. Each enrolled patient was treated with 2 gm PAM intravenously as the loading dose. The control group was treated according to the WHO's recommended PAM regimen, and the experimental group was treated according to their APACHE II scores and dynamic changes in BuChE activity. If a patient's APACHE II score was ≧26 or there was no elevation in BuChE activity at the 12th hour when compared to the 6th, doses of 1 g/h PAM (i.e., doubled WHO's recommended PAM regimen) were given. The levels of the serum BuChE and red blood cells acetylcholinesterase and the serum PAM levels were also measured.ResultsForty-six organophosphate poisoning patients were enrolled in this study. There were 24 patients in the control group and 22 patients in the experimental group. The hazard ratio of death in the control group to that of the experimental group was 111.51 (95% CI: 1.17–1.613.45; p = 0.04). The RBC acetylcholinesterase level was elevated in the experimental group but was not in the control group. The experimental group did not exhibit a higher PAM blood level than did the control group.ConclusionThe use of PAM can be guided by patient severity. Thus, may help to improve the outcomes of organophosphate poisoning patients.

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“…Serum BChE activity has been broadly used as a biomarker for various diseases [ 17 , 18 ], although its function has not been definitely clarified. In the clinic, it is most widely used for the assessment of organophosphate poisoning [ 8 ]. Organophosphates, as well as other forms of environmental toxin exposure, are risk factors for Parkinson's disease [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…The cholinergic system is involved in many physiological functions of the central nervous system, and Ach can be hydrolyzed by acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), two independent enzymes in the circulation system. Serum BChE is mainly synthesized in the liver and can be clinically used as a marker of organophosphate poisoning [ 8 ]. However, increasing evidence suggests that BChE activity is also associated with disease severity and can be used to predict prognosis in many diseases [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Serum Butyrylcholinesterase Activity: A Biomarker for Parkinson’s Disease and Related Dementia

Dong

et al. 2017

BioMed Research International

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Objective This study aim to determine changes of serum butyrylcholinesterase (BChE) activity in PD patients and related dementia. Patients and Methods Consecutive PD patients and healthy controls were included and clinical data were collected. Fast serum BChE activity was determined and compared between healthy controls and PD patients. Independent risk factors were performed for BChE activity, PD, and related dementia. The relationship between BChE activity and disease severity was also evaluated. Receiver operating characteristic (ROC) curves were obtained to explore serum BChE activity in distinguishing PD patients and related dementia. Results Serum BChE activity mainly independently correlated with gender, albumin, triglyceride, body mass index, and PD. Serum BChE activity decreased in PD patients compared with healthy controls. Based on the ROC curve, the optimal cut-off point was 6864.08 IU/L for distinguishing PD patients, and the sensitivity and specificity values were 61.8% and 72.1%. It inversely correlated with Unified Parkinson's Disease Rating Scale score. BChE activity decreased in PD-related dementia compared with those without dementia. The sensitivity and specificity values were 70.6% and 76.3%, respectively, with an optimal cut-off point of 6550.00 IU/L. Conclusions Serum BChE activity can be regarded as a biomarker for PD and related dementia.

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Prognostic value of serial serum cholinesterase activities in organophosphate poisoned patients

Cited by 18 publications

References 14 publications

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

A retrospective review of intensive care management of organophosphate insecticide poisoning: Single center experience

The effectiveness of patient-tailored treatment for acute organophosphate poisoning

Serum Butyrylcholinesterase Activity: A Biomarker for Parkinson’s Disease and Related Dementia

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