Outcome of patients with OPC poisoning who require mechanical ventilation: a statistical analysis
Keywords:Atropin, Organophosphorous poisoning, Parathion, Poisoning
Background: Poisoning constitutes about 60% of deliberate self-harm in rural Asia. OPCs account for 80% of pesticide poisoning. Ravi et al reported the incidence of organophosphorous poisoning as around 1.26 lakhs in India. Patients will be required ventilator support for management in most of cases and hence study is being done to find the association of factors in patients with prolonged ventilator support.
Methods: Statistical analysis was carried out for 50 patients after categorizing each variable like age, sex, type of compound, quantity, serum pseudo cholinesterase levels, respiratory failure, intermediate syndrome and other clinical signs.
Results: Out of 50 patients 74% of patients required more than 10 days of ventilation and methyl parathion was the frequent compound associated with prolonged ventilation and 60% of patients who required 4-8 days of atropinisation and also patients who had low pseudocholinesterase levels at the onset had required prolonged ventilation.
Conclusions: The results show that outcome of patients with OPC poisoning is associated with type of compound, period of atropinisation, quantity, pseudocholinesterase levels. So immediate treatment is most important to improve mortality in OPC poisoning.
Eddleston M, Rezvi MH, Hawton K. Deliberate self harm in Sri Lanka: an overlooked tragedy in the developing world. BMJ. 1998:317(7151);133-5.
Senanayake N, Karalliede L. Neurotoxic effects of organophosphorous insecticides. N Engl J Med. 1987;316:761-3.
Taylor, Francis. Environmental health perspectives. Journal Toxicology Environmental Health. 1994;102:1.
Shailesh KK, Pais P, Vengamma, Muthane U. Clinical and electrophysiological study ofintermediate syndrome in patients with organ-ophosphorous poisoning. JAPI.1994;42(6):451-3.
Wadia RS, Sadagopan C, Amin RB, Sardesai HV. Neurological manifestations of organophosphorous insecticide poisoning. J Neurol Neurosurg Psychiatry. 1974;37(7): 841-7.
Noshad H, Ansarin K, Ardalan MR, Ghaffari AR, Safa J, Nezami N. Respiratory failure in organophosphate insecticide poisoning. Saudi Medical Journal. 2007;28(3):405-7.
Basu A, Das AK, Chandrashekar S. Organophosphate poisoning - a clinical profile. J Assoc Physicians India. 1988:36:24.
Rajeev H, Arvind MN. Study of clinical and biochemical parameters in predicting the need for ventilator support in organophosphorus compound poisoning. J Evolution Med Dental Sci. 2013;2(49):9555-70.
Aziza MH, Sultan ST. Organo-phosphorus insecticide poisoning: management in surgical intensivecare unit. J Coll Physicians Surg Pak. 2005;15(2):100-2.
Karalliedde L, Senanayake N: Organo-phosphorus insecticide poisoning. Br J Anaesth. 1989;63:736-50.
Samuel J, Thomas K, Jeyaseelan L, Peter JV, Cherian AM. Incidence of intermediate syndin organophosphorus poisoning. Assoc Physicians India.1995;43:321-3.
Ahmed SM, Das B, Nadeem A, Samal RK. Survival pattern in patients with acute organophosphate poisoning on mechanical ventilation, a retrospective intensive care unit-based study in a tertiary care teaching hospital. Indian J Anaesth. 2014;58:11-7.