Pseudocholinesterase as a predictor of mortality and morbidity in organophosphorus poisoning

Abstract

Background:Organophosphorus (OP) pesticide poisoning is a major clinical and public health problem in India. Mortality rate remains high at 15%–30%.Aims:This prospective, observational study examines the relationship between pseudocholinesterase (PChE) activity and morbidity and mortality in OP poisoning.Setting and Design:OP poisoning cases admitted to a tertiary care center Intensive Care Unit (ICU) over 5 years from 2010 to 2014 were studied.Methods:Patients <16 years of age, those on steroids and those with neuromuscular weakness, were excluded from the study. Serum PChE level at admission was estimated and the severity of poisoning assessed accordingly. Primary outcome measures were ICU length of stay and ventilator-free days. Secondary outcome measures included vasopressor-free days, amount of atropine given, hospital length of stay, and ICU mortality.Results:There were 37 patients included in the study, aged between 24 and 44 years, of which 65% were male. They were divided into two groups according to PChE levels. Group A with PChE levels more than 1000 IU/L had twenty patients and Group B with levels <1000 IU/L had 17 patients. Group B had longer ICU length of stay (P < 0.001) and fewer ventilator-free days (P < 0.001). They also had a fewer vasopressor-free days and a longer stay in hospital.Conclusions:PChE level at presentation is a reliable indicator of the severity of OP poisoning and a predictor of the need for mechanical ventilation and the duration of stay in the ICU.

Effects of IL-10 on OX62, MHC-II and CD86 in bone marrow DCs in rats with organophosphate poisoning

“…Organophosphorus poisoning is a common critical acute condition, the disease progresses quickly, without timely treatment it can deteriorate in a short time with high mortality ( 9 ). The poison combine with the cholinesterase after entering into the body, leading to cholinergic neurotransmitter mass accumulation at the neuromuscular junction, resulting in severe neurological disorders ( 6 , 10 ). Most of these critical patients have combined MODS, and the prognosis is poor.…”

Respiratory Failure Following Organophosphate Poisoning: A Literature Review

“…Two studies report tracheostomy done among patients. Hiremanth et al report 21 patients (56.7%) out of 37 patients with tracheostomy, whereas Kang et al report 17 patients (25%) out of 68 patients with tracheostomy [ 26 - 27 ].…”

“…Group A included patients with PChE levels greater than 1000 IU/L, whereas Group B included those having PChE levels less than 1000 IU/L. Group B patients had greater failure rates in weaning off mechanical ventilation, a higher rate of tracheostomy, a longer hospital stay, and a higher mortality rate [ 26 ]. APACHE II is used to measure the severity of disease in patients admitted to the intensive care unit.…”

Association between ECG Alterations and Outcomes of Patients with Acute Organophosphate Poisoning

“…Therefore, the cholinergic nerve is stimulated, and a varieties of symptoms appear. 4,5 The main SLUDGE signs of OPs poisoning are salivation, lacrimation, urination, defecation, gastrointestinal upset, and emesis. 6 The cardiac manifestations of OPs poisoning occur in a majority of affected patients and may range from harmless electrocardiographic (ECG) changes such as sinus tachycardia, to life-threatening complications such as cardiogenic pulmonary edema.…”