Management of organophosphorus compound poisoning -A one year experience in a tertiary care hospital.
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Date
2012-01
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Abstract
This study was undertaken to assess the distribution pattern, outcome and possible predictors affecting the mortality and the need for ventilator support in patients who had consumed organophosphorus compound pesticides. 91 patients who were admitted to the ICU between April 2009 and March 2010 with history of ingestion of organophosphorus pesticide, were studied. Baseline clinical assessment and investigations were undertaken and SOFA and APACHE II scores were calculated.
Out of 91 patients, 39 required ventilator support. Of these 39 patients, 2 died, one due to severe sepsis and multiorgan dysfunction, and the other, a chronic alcoholic with chronic liver disease, due to hepatic encephalopathy and multiorgan dysfunction. The time elapsed since ingestion of poison, SOFA and APACHE II scores were significantly associated with patients requiring ventilator support. However with logistic regression analysis, none of these variables were able to either predict mortality or the need for ventilator support.
The overall outcome in these cases was favourable as the mortality rate was 2.3%. Though the time elapsed since ingestion of the pesticide and the APACHE II score were found to predict the need for ventilation in many earlier studies, they failed to predict either the need for ventilation or mortality in the present study. The improved mortality rate could be attributed to an organized approach through protocols between the emergency department and the ICU in order to successfully manage patients with organophosphorus compound poisoning.
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Keywords
Organophosphorus compound (OPC), Pesticide, Mechanical ventilation, APACHE II, SOFA
Citation
Vaidyanathan R, Ashoka H G, Kumar G N Pramod. Management of organophosphorus compound poisoning -A one year experience in a tertiary care hospital. Journal of the Indian Society of Toxicology. 2012 Jan; 8(1): 38-42.