The relationship between serum ammonia level and neurologic complications in patients with acute glufosinate ammonium poisoning: A prospective observational study

Abstract

Glufosinate ammonium poisoning can cause neurological complications even after a symptom-free period. We prospectively investigated the predictors of neurologic complications in acute glufosinate ammonium poisoning and the change of serum ammonia level as a predictor of patient's presence and recovery of neurologic complication. This prospective observational study collected data from consecutive patients diagnosed with acute glufosinate ammonium poisoning between September 2014 and June 2016. Serum ammonia was serially measured. The patients were divided into two groups: the neurologic complication group and the nonneurologic complication group. We also defined 25 other insecticide- or herbicide-poisoned patients as controls. The neurologic complication group included 18 patients (72.0%). The latency period for neurologic complications was within 48-h postingestion. The peak ammonia level was statistically higher in the neurologic complication group than in the control group ( p < 0.001) and the nonneurologic complication groups ( p = 0.001). There was a statistical difference between the nonneurologic complication group and the neurologic complication group ( p = 0.0085) in terms of ingested amount. The peak ammonia was the only predictor for the development of neurologic complications (the optimal cutoff: 90 μg/dL). In patients with mental changes, the mean serum ammonia levels before and after recovery of the mental changes were statistically different ( p = 0.0019). In acute glufosinate ammonium poisoning, serial serum ammonia level measurements are needed and a serum peak ammonia level greater than 90 μg/dL is a predictor of neurologic complications. Also, it is important to treat the hyperammonemia in acute glufosinate ammonium poisoning.

Egg quality, hatchability, gosling quality, and amino acid profile in albumen and newly-hatched goslings’ serum as affected by egg storage

“…On hatching day, 3 birds were randomly selected from each replicate for blood collection from the wing vein using a sterile syringe. Blood samples and frozen albumen samples were used for amino acid profile analysis using Hitachi 835-50 amino acid automatic analyzer and ammonia concentration analysis by Dimension Vista Ammonia method ( Cha et al, 2018 ). Samples were homogenized and then moved to a sealed tube with 10 mL of 6 mol/L HCl.…”

Residuos de plaguicidas y el trastorno del espectro autista

“…El glufosinato de amonio (GLA) es un herbicida que se utiliza ampliamente en todo el mundo [31]. Un estudio realizado por Aris and Leblanc [32] encontró que un metabolito del GLA (ácido 3metilfosfinicopropiónico) podría detectarse en casi todas las muestras de suero sanguíneo de un grupo de pares madre-hijo, lo que indica una exposición universal y una potencial exposición transplacentaria.…”

“…Un estudio realizado por Aris and Leblanc [32] encontró que un metabolito del GLA (ácido 3metilfosfinicopropiónico) podría detectarse en casi todas las muestras de suero sanguíneo de un grupo de pares madre-hijo, lo que indica una exposición universal y una potencial exposición transplacentaria. Aunque, la neurotoxicidad del GLA está bien documentada [31,33], los mecanismos subyacentes a través de los cuales GLA impactan el desarrollo del SNC siguen siendo desconocidos en gran parte. En este sentido, Dong, Guan [6] utilizaron un modelo animal de ratón para estudiar los efectos de la exposición prenatal del GLA.…”

Serum ammonia as an early predictor of in-hospital mortality in patients with glufosinate poisoning

“…All patients with hyperammonemia upon ED arrival received a lactulose enema to lower their ammonia levels based on a serum ammonia level of 86 mg/dL, as high levels have been suggested to cause neurologic complications. 6,7 Some of the participants were excluded based on the following criteria: (1) age below 19 years, (2) poisoning involving other agents except alcohol, (3) transfer to another hospital after ED admission, and (4) insufficient data.…”

“…A few studies reported that measuring serum ammonia levels at the ED or serial ammonia levels are useful for predicting neurologic complications, such as decreased mental status, seizure, or amnesia in glufosinate poisoning. [5][6][7] However, there is no study of whether serum ammonia concentration predicts inhospital mortality in the early phase of glufosinate poisoning. The sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scoring systems are tools widely used for predicting the clinical outcomes of patients admitted to the intensive care unit (ICU).…”