Survival pattern in patients with acute organophosphate poisoning on mechanical ventilation: A retrospective intensive care unit-based study in a tertiary care teaching hospital

Das, Bikramjit; Nadeem, Abu; Samal, Rajiv Kumar

doi:10.4103/0019-5049.126780

Cited by 32 publications

(39 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This observation was in line with many other researchers. 7,11,16,19,[29][30][31] Senanayake and Karalliedde classified "type II Paralysis" 33 as "intermediate syndrome" and described it as a distinct clinical entity on the basis of electromyographic (EMG) findings of postsynaptic neuromuscular junction (NMJ) failure that had occurred between 24 and 96 h after the resolution of the initial cholinergic crisis and prior to the onset expected for delayed neuropathy. 32 The respiratory muscles are often affected and patients require prolonged periods of ventilatory support and are associated with its complications.…”

Section: Variablementioning

confidence: 99%

“…In present study, variety of complication were observed (Table 12). [12][13][14][15][16] Individuals in this age group are active physically, mentally and socially and thus more prone to various stresses. The present study had more number of illiterate and those studied below intermediate level with majority of cases being related directly or indirectly to farming.…”

Section: Variablementioning

confidence: 99%

See 1 more Smart Citation

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

Mundhe¹,

Birajdar²,

Chavan³

2017

Int J Adv Med

View full text Add to dashboard Cite

Background: Organophosphates (OP) are commonly used and potentially fatal insecticides. Given the unrestricted availability and widespread use, OP poisoning is very much common following either accidental or intentional exposures. Many parameters are proposed to predict outcome, yet there is no consensus about these parameters. This study aimed to investigate different factors associate with morbidity and mortality in rural population that can help in identifying patients in need of intensive care and treatment to prevent deaths.Methods: This was a cross-sectional observational study of 323 patients, admitted to the tertiary care rural public hospital with OP poisoning between December 2015 to November 2016.Results: Of the 323 patients studied, 62.85% were male, 227 (70.27%) were suicides, 241 (74.61%) ingested OP compounds, 40 (12.38%) patients developed intermediate syndrome and 56 (17.34%) died. There were statistically significant differences between ventilatory support group and no ventilatory group for suicidal intention, sex, comorbid psychiatric conditions, route of exposure, certain clinical features on admission, GCS score, POP scale, time from exposure to initiation of treatment, plasma pseudocholinesterase levels, oxygen saturation, and random blood sugar levels (p<0.05).Conclusions: OP poisoning is a life-threatening condition which requires immediate management. Early initiation of decontamination, atropine and pralidoxime therapy, with supportive ICU care, can save lives. Different demographic, exposure related parameters; some of the clinical features, treatment variables and certain laboratory findings can provide useful prognostic information and help to predict outcomes. A measures to control unchecked availability of these compounds and early transfer of victims to health care facility is needed to save many lives.

show abstract

Section: Variablementioning

confidence: 99%

Section: Variablementioning

confidence: 99%

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

Mundhe¹,

Birajdar²,

Chavan³

2017

Int J Adv Med

View full text Add to dashboard Cite

show abstract

“…It says that poisoning is more common among males being 60.46%; the mean age group is 30.51±10.78 year and the cause is a suicidal intention [11]. In our case, the poison being a rare poison, the figure is very small to comment on, but (8/11) 72.7% were males, mean age was 43.70 year (range -23-56 year), and the purpose was suicidal showing similar demographic We received all moderate-to-severe cases of poisoning.…”

Section: Discussionmentioning

confidence: 99%

An Observational Study of 11 Cases of Cartap Poisoning - A Rare Poisoning

Das¹,

Mohanty²,

Behera

et al. 2017

Asian J Pharm Clin Res

View full text Add to dashboard Cite

Objective: Cartap hydrochloride poisoning is an uncommon poisoning encountered in India. The aim of this study was to assess the characteristics, severity, management, and outcome of patients with Cartap poisoning, treated with N-acetylcysteine (NAC) in intensive care unit (ICU) of a tertiary referral hospital.Methods: This is a retrospective study where 11 cases of Cartap poisoning admitted to hospital ICU between 2011 and 2016 were identified from the case records. The demographic data, mode of ingestion, time to treat, ingested dose and severity of poisoning, presenting features, duration of mechanical ventilation (MV), dose of NAC used, complications, and outcome were noted.Results: Patients were scored as moderate or severe cases of poisoning. Severe cases consumed >10 g, underwent gastric lavage > 4 hrs, and took Cartap concomitantly with alcohol or in empty stomach. Duration of MV varied from 68-94 hrs in severe cases and 12-48 hrs in moderate cases. Average dose of NAC in severe case was 11.19 g and moderate case was 8.89 g. The most common presenting symptoms were vomiting, altered sensorium, and breathlessness. Severe cases had more complications, and the most common complication was hypotension followed by seizures. Survival was 100%.Conclusion: 50% of Cartap poisoning cases had good survival outcome. Severity of poisoning depends on amount of Cartap ingested, time taken for gastric lavage, and concomitant administration of alcohol. Duration of MV and dose of NAC and complications encountered correlates with the severity of poisoning.

show abstract

“…5 Many studies are conducted on OPC to recognize their etiology, incidence, risk factors associated and treatment. 4,6,7 But still there is a lack of exact information related to pathophysiology and information regarding clinical profile and outcome of patients that causes IMS. Hence, this study was conducted with the aim to study the clinical profile of IMS in patients with OPC poisoning, to evaluate the frequency IMS in relation to various types of OPC, to study the outcome of IMS in terms of recovery or death and to correlate the outcome of IMS with type of compound, duration of IMS, respiratory failure, serum cholinesterase and serum creatinine kinase levels.…”

Section: Introductionmentioning

confidence: 99%

“…In developing country like India, pesticide self-poisoning is responsible in killing many people of rural areas as these compounds are easily available at cheaper cost and the mortality rate was as higher as 70%. [2][3][4] OPC shows their action in humans in three phases namely acute cholinergic crisis, intermediate syndrome (IMS) and delayed neuropathy. Among them IMS is the major contributing factor of OPC related toxic effects and mortality.…”

Section: Introductionmentioning

confidence: 99%

Clinical profile and outcome of intermediate syndrome in acute organophosphate poisoning

2018

View full text Add to dashboard Cite

Background: Deaths by acute organ phosphorus poisoning is very common in rural India especially in people associated with agriculture sector. The present study was aimed to study the clinical characteristics of organ phosphorus compound (OPC) poisoning and to assess the associated factors related to the outcome (recovery/death) of intermediate syndrome (IMS). Methods: This is an observational study conducted on 40 patients showing features of intermediate syndrome at Poison center, Institute of internal medicine, Rajiv Gandhi Government General Hospital, Chennai. Detailed clinical examination was done on the day of admission and daily with close monitoring. All patients included under study will be treated with pralidoxime as per protocol, atropine as required and other supportive measures was provided. Mechanical ventilatory support was provided for patients in respiratory failure. Patients are followed up till the end point of outcome (recovered and discharged/death) that was correlated with type of compound, quantum of exposure, duration of IMS, serum cholinesterase and creatinine kinase levels and respiratory failure. Results: Patients of age group between 30-40 years are more affected. Males outnumbered the females and most of them are from agriculture sector (65%). Out of 40, on treatment and follow up 34 patients were recovered and 6 were died. Onset of intermediate syndrome ranges between days 2-4 following exposure and duration of symptoms was observed for 5-16 days. Methylparathion was the frequent compound associated with IMS in about 9 cases. Out of 40, 16 had respiratory failure and given ventilator support. Proximal muscle weakness was seen in about 38 patients as common symptom. Conclusions:The results of the present study concludes that factors such as mode of poisoning, onset of IMS, type of compound, PChE level are not correlated with the outcome of study. Duration of IMS, respiratory failure, ventilator associated pneumonia (VAP), ventilator support duration were associated with outcome of the study. Hence, early recognition of IMS and its associated respiratory paralysis is very important in patients affected with OPC toxicity to prevent morbidity and mortality rate.

show abstract

Survival pattern in patients with acute organophosphate poisoning on mechanical ventilation: A retrospective intensive care unit-based study in a tertiary care teaching hospital

Cited by 32 publications

References 14 publications

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

The clinico-demographic study of morbidity and mortality in patients with organophosphate compound poisoning at tertiary care hospital in rural India

An Observational Study of 11 Cases of Cartap Poisoning - A Rare Poisoning

Clinical profile and outcome of intermediate syndrome in acute organophosphate poisoning

Contact Info

Product

Resources

About