HYPOKALAEMIA IN ORGANOPHOSPHOROUS COMPOUND POISONING
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 84
Abstract
BACKGROUND Inhibition of cholinesterase plays a key role in organophosphate (OP) toxicity. There are other factors which contribute to the severity of poisoning. One of them is electrolyte imbalances such as hypokalaemia. The aim of our study was to find out the value of hypokalaemia in association with plasma cholinesterase (PChE) levels in assessing the morbidity and mortality of OP poisoning. MATERIALS AND METHODS In this cross-sectional study, patients with definitive history of OP poisoning were taken as subjects. Pre-interventional clinical features were observed and noted with severity assessment as per Proudfoot’s classification along with measurement of serum potassium ion ([K+]) concentration and PChE level. RESULTS Fifty OP poisoned patients (32 men, 18 women) were enrolled with median age of 30 years. The most common clinical manifestation was Respiratory distress (50%) followed by fasciculation and neck muscle weakness (44%) followed by diaphoresis (30%) and others. A total of 28 cases presented with one or more severe clinical features according to Proudfoot classification, among them 56% of cases (20 out of 28) developed hypokalaemia. Muscle weakness or fasciculation developed with mean serum [K+] of 3.39 ± 0.60. Ventilatory support was required at the mean serum [K+] of 3.47 ± 0.66 mmol/L. No fatality was noted. Correlation of the severe clinical features and serum [K+] was significant (P < 0.05). We also noted that severe clinical features were associated with marked suppression of PChE (> 50%). CONCLUSION Serum [K+] and PChE level are greatly reduced in patients with OP poisoning with severe clinical features. Hence, these biochemical markers can be considered predictors of outcome in OP poisoning. Physicians should consider hypokalaemia associated with reduced PChE level as alarming signs of poor prognosis in OP poisoned patients and the need for ICU admission and ventilatory support.
Authors and Affiliations
Diwakar Tumkur Narasimhamurthy, Shubha Vishnu Hegde
Keywords
Related Articles
- EP ID EP276386
- DOI 10.14260/jemds/2017/1267
- Views 66
- Downloads 0
COMPARING HIGH INTENSITY WITH LOW INTENSITY STATINS IN ACHIEVING OPTIMAL LDL GOALS AMONG CORONARY ARTERY DISEASE PATIENTS IN SUBURBAN POPULATION IN SOUTH INDIA
BACKGROUND Patients with ischemic heart disease (IHD), including those with an acute coronary syndrome (ACS), should receive long-term, intensive lipid-lowering statin therapy. Target levels of low-density lipoprotein ch...
COMPARITIVE STUDY OF LOCAL STEROID INJECTION VERSUS AUTOLOGOUS BLOOD INJECTION THERAPY FOR THE MANAGEMENT OF LATERAL EPICONDYLITIS
[b]OBJECTIVES:[/b] Local corticosteroid infiltration is a common practice of treatment for lateral epicondylitis. In recent studies no statistically significant or clinically relevant results in favour of cor...
ERYTHRODERMA- CLINICOPATHOLOGICAL CORRELATION IN NORTH BENGAL POPULATION
BACKGROUND Erythroderma or exfoliative dermatitis is an inflammatory disorder, it covers > 90% of the body surface. Hebra proposed it first in 1868. Pre-existing dermatoses comprised majority of cases and these include p...
ULTRASOUND BIOMICROSCOPIC ASSESSMENT OF ANGLES BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN PRIMARY ANGLE CLOSURE AND PRIMARY ANGLE CLOSURE GLAUCOMA PATIENTS
BACKGROUND Acute angle closure glaucoma is a potentially preventable condition and hence early identification and treatment of susceptible patients is of utmost importance. Screening, thus is essential so that timely man...
CEREBROVASCULAR ACCIDENTS IN PATIENTS OF CHRONIC RENAL FAILURE WITH ALTERED SENSORIUM PRESENTING IN EMERGENCY
BACKGROUND Cerebrovascular disease is a devastating expression of vascular risk in CKD and yet, in comparison to cardiac disease, is relatively understudied. It is vital to understand the risks as well as benefits of est...