A STUDY OF PREDICTING THE NEED FOR VENTILATOR SUPPORT AND OUTCOME IN ORGANOPHOSPHORUS POISONING
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 29
Abstract
BACKGROUND Organophosphorus compound poisoning is the most common poisonings in India because of easy availability, often requiring ICU care and ventilator support. Clinical research has indicated that respiratory failure is the most important cause of death due to Organophosphorus poisoning. It results in respiratory muscle weakness, pulmonary oedema, respiratory depression, increased secretions and bronchospasm. These complications and death can be prevented with timely Institution of ventilator support. The aim of present study was to identify the factors and predicting the need for ventilator support and outcome. Aim of the Study- To predict the need for ventilator support and outcome in organophosphate poisoning. MATERIALS AND METHODS Seventy consecutive patients admitted with a history of organophosphorus poisoning at KIMS, Hubli were taken for study after considering the inclusion and exclusion criteria. Detailed history, confirmation of poisoning, examination and other than routine investigations serum pseudocholinesterase and arterial blood gas analysis was done. The severity of organophosphorus poisoning was graded as mild, moderate and severe based on the factors which influence the need for ventilator support. RESULTS This study was conducted in 70 patients, out of which 48 (68.6%) were male patients and 22 (31.4%) were female patients. Among them 37 (53%) patients required ventilation and 33 (47%) expired. Chlorpyrifos, Dichlorvos and Monocrotophos were most commonly consumed poisons. 74% patients who consumed these compounds required ventilator support and 73% patients expired. 100% of patients presented with pin point pupil, fasciculation score > 4, respiratory rate > 20, GCS score < 7 and severe grade of poisoning required ventilator support and pseudocholinesterase < 900 U/L, 70% of metabolic acidosis and atropine requirement more than 180 mg within 48 hours required ventilator support and associated with high mortality. CONCLUSION Patients who presented with pinpoint pupils, bradycardia, higher respiratory rate, generalised fasciculation, low GCS score, low pseudocholinesterase levels, moderate-to-severe grade of poisoning, metabolic acidosis and higher requirement of atropine within 48 hours were the strong predictors of ventilation in organophosphorus poisoning and associated with high mortality.
Authors and Affiliations
Kalinga Bommankatte Eranaik, Nagraj Nagraj, Basith Lateef Kardkal
Keywords
Related Articles
- EP ID EP217811
- DOI 10.18410/jebmh/2017/327
- Views 94
- Downloads 0
COMPARISON OF ANTI-INFLAMMATORY ACTIVITY OF ALPINIA GALANGAL IN THREE EXPERIMENTAL ANIMAL MODELS
Inflammation is not a disease but a non-specific response of the body defence1 . Anti-inflammatory drugs have become popular because of their ability in controlling the inflammatory reaction and mitigating the suffering...
CLINICAL CHARACTERISTICS AND SHORT-TERM OUTCOMES OF POST-MYOCARDIAL INFARCTION VENTRICULAR SEPTAL RUPTURE- A RETROSPECTIVE STUDY
BACKGROUND We wanted to evaluate the patient characteristics, risk factors, short-term outcomes and predictors of poor outcomes in patients with ventricular septal rupture developed as a complication of acute myocardial...
CONSERVATIVE VERSUS OPERATIVE TREATMENT OF DISPLACED MID SHAFT CLAVICLE FRACTURE- A TWO YEARS RANDOMIZED CONTROLLED STUDY
BACKGROUND Clavicle fractures were considered non-troubling entity in the past. Majority of mid shaft fractures used to be treated conservatively and many studies reported relatively good results. However, more recent st...
28 CASES OF TRAUMATIC POSTERIOR FOSSA EXTRA DURAL HEMATOMA OUR EXPERIENCE: CASE SERIES
A retrospective study of 281 cases of traumatic posterior fossa Extra dural hematoma2,3 in King George Hospital, Visakhapatnam from August 2012 to February 2015. This study was aimed to present the experience in treating...
INCIDENCE OF VARIOUS ARRHYTHMIAS AND ITS PROGNOSIS IN DIFFERENT TYPES OF ST SEGMENT ELEVATION MYOCARDIAL INFARCTION IN FIRST 72 HOURS
BACKGROUND ST elevation myocardial infarction is an acute emergency, more than 50% of deaths due to STEMI occur within first 1 hour, mainly due to various arrhythmias. Various arrhythmia can complicate the course of STEM...