Serum creatine phosphokinase as predictor of intermediate syndrome in organophosphorus poisoning

kumar, guresh C.; Bhuvana, K.; Venkatarathnamma, P N; Sarala, N

doi:10.4103/0972-5229.160274

Cited by 14 publications

(15 citation statements)

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“…The correlation between initial CPK levels and poison severity was reported by Bhattacharyya et al, Nermeen et al and Sen R et al (2,9,10) . Similar result was also obtained in studies conducted by D. Markandeyulu et al and Kumar et al (11) study. It also correlated with the incidence of need for ventilator support and outcome.…”

Section: Discussionsupporting

confidence: 90%

Creatine Phosphokinase: A Prognostic Marker in Organophosphorus Compound Poisoning

Balasubramaniyan¹

2018

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Background: In developing countries like India, organophosphorus compounds (OPC) constitutes for 80% of pesticide poisoning. Creatine phosphokinase (CPK) is emerging recently as a prognostic marker in OPC poisnoning. This study is done to analyse the clinical utility of CPK in OPC poisoning patients. Aim: To estimate Serum CPK levels in patients who have consumed Organophosphorous compound (OPC) poisoning and to assess the role of Serum CPK (CPK) as a marker of severity and correlate it withthe incidence of respiratory failure and final outcome in OPC poisoning. Materials and Methods: 50 patients of acute OPC poisoning, aged 14 years and above, admitted in Rajah Muthiah medical college and hospital, within 6 hours of exposure irrespective of route of exposure and sex were selected and subjected for study. They were assessed clinically on admission by Peradeniya OPC Poisoning scales and categorized according to the severity. Then, they were also subjected to estimation of serum CPK at the time of admission and 48 hours after admission.Results: CPK values were increased among 60% of study group at 0 hours and 68% at 48 hours. There was a significant increase in serum CPK levels from 0 to 48 hours which is of high statistical significance (p =0.001). Conclusion:The correlations of serum CPK with outcomes such as ventilatory function and survival of the patient were statistically significant and positive at both periods of measurement. Therefore, serum CPK measurement is not only crucial at 0 hours, it is equally important to have serial monitoring of serum CPK levels, which ultimately tells the prognosis of the patients.

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Section: Discussionsupporting

confidence: 90%

Creatine Phosphokinase: A Prognostic Marker in Organophosphorus Compound Poisoning

Balasubramaniyan¹

2018

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“…a syndrome characterized by muscular weakness, especially of the respiratory muscles and proximal limbs muscles. High levels of CPK contributed to a period of intermediate syndrome with significantly increased values after 48 hours [24].…”

Section: Discussionmentioning

confidence: 99%

Assessment of hospitalizations of patients after intoxication with organophosphates used in agriculture

Orzeł¹,

Flieger²,

Szlichta³

et al. 2022

Ann Agric Environ Med.

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Introduction. Clinical manifestation of organophosphates toxicity may be differentiate and include cholinergic toxidrome, intermediate syndrome, OP-induced delayed polyneuropathy to chronic OP-induced neuropsychiatric disorder (OPIDN). Patients symptoms, along with decrease in cholinesterase serum level, determines the possible diagnosis of organophosphate poisoning.Objective. The aim of the study was to present the clinical manifestation and cholinesterase level changes in intoxication with organophosphorus compounds in patients. Materials and method. A data base was created by analysis of the hospital documents of 34 patients hospitalized due to organophosphate intoxication. Statistical analysis involved frequency tables with percentage values, the application of non-parametric Chi-square test and parametric t-Student test (with homogeneity of variance Levine test). The level of static significance was set to p=0.05. Results. In fatal hospitalizations (20.6%), cholinesterase level was significantly lower (265.87 U/l) than in other patients (4254.78 U/l; p<0.05). Similarly, levels of cholinesterase were decreased in group of patients with acute respiratory failure (999.79 U/l vs 4943.86 U/l in other patients; p<0.05), patients with multi-organ dysfunction syndrome (244.13 U/l vs 4914.89 U/l in other patients; p<0.05) and those with cardiac arrest (547 U/l vs 4636.25 U/l in other patients). A statistically significant difference was also observed in cholinesterase level of patients who required mechanical ventilation (548.17 U/l vs 5219.71 U/l in other group). The study revealed that 29.4% of poisonings were suicidal. Conclusions. The management of a patient with organophosphate poisoning remains challenging and requires continuous control. A significant step in the diagnostic process is the assessment changes in both the clinical picture and cholinesterase level.

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“…El tiempo de exposición depende del tipo, la cantidad y la vía de entrada del tóxico (2,15). De acuerdo con ello, los síntomas y signos clínicos de las intoxicaciones por of (iof) se clasifican en manifestaciones colinérgicas, el síndrome intermedio y la neuropatía retardada (16). (24).…”

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Síndromes asociados a intoxicación por organofosforados: abordaje médico y fisioterapéutico en cuidado crítico

2019

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Introducción: el artículo reporta un caso clínico de intento suicida de un paciente con síndrome intermedio a causa de intoxicación por organofosforados. Para ello se analizó la historia clínica, los exámenes complementarios y el estudio electromiográfico, y se realizó revisión no sistemática de la literatura. Presentación del caso: se describe un caso diagnosticado en la unidad de cuidado intensivo, el cual presentó trastornos neuromotores, requerimiento de soporte ventilatorio con destete difícil y extubación fallida, así como el tratamiento médico y fisioterapéutico instaurado. Dentro del manejo de la intoxicación por organofosforados se incluye la descontaminación del tóxico, administración de atropina y pralidoxima, diagnóstico oportuno del síndrome intermedio y la prescripción de ejercicio terapéutico. El paciente recibió manejo interdisciplinario, logrando liberación de su condición crítica, pero con persistencia de debilidad muscular proximal; sin embargo, con el ejercicio alcanzó recuperación funcional de sus actividades básicas cotidianas. Conclusión: el panorama mundial de las intoxicaciones por sustancias químicas muestra que son causa de morbilidad y discapacidad importante. Los organofosforados son los plaguicidas más frecuentemente involucrados. Los síntomas y signos clínicos de este tipo de intoxicaciones se clasifican en manifestaciones colinérgicas, el síndrome intermedio y la neuropatía retardada.

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Serum creatine phosphokinase as predictor of intermediate syndrome in organophosphorus poisoning

Cited by 14 publications

References 12 publications

Creatine Phosphokinase: A Prognostic Marker in Organophosphorus Compound Poisoning

Creatine Phosphokinase: A Prognostic Marker in Organophosphorus Compound Poisoning

Assessment of hospitalizations of patients after intoxication with organophosphates used in agriculture

Síndromes asociados a intoxicación por organofosforados: abordaje médico y fisioterapéutico en cuidado crítico

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