Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan
Poisoning due to organophosphate pesticides is an important cause of morbidity and mortality worldwide. Although standard treatments involving the administration of atropine and oximes have been used, there remain many controversial areas concerning organophosphate poisoning (OPP). Herein, we presen...
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| Format: | Article |
| Language: | English |
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Wiley
2007-03-01
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| Series: | Kaohsiung Journal of Medical Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X09703857 |
| _version_ | 1819116401606000640 |
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| author | Jong-Rung Tsai Chau-Chyun Sheu Meng-Hsuan Cheng Jen-Yu Hung Chuan-Sheng Wang Inn-Wen Chong Ming-Shyang Huang Jhi-Jhu Hwang |
| author_facet | Jong-Rung Tsai Chau-Chyun Sheu Meng-Hsuan Cheng Jen-Yu Hung Chuan-Sheng Wang Inn-Wen Chong Ming-Shyang Huang Jhi-Jhu Hwang |
| author_sort | Jong-Rung Tsai |
| collection | DOAJ |
| description | Poisoning due to organophosphate pesticides is an important cause of morbidity and mortality worldwide. Although standard treatments involving the administration of atropine and oximes have been used, there remain many controversial areas concerning organophosphate poisoning (OPP). Herein, we present our 10 years of experience in assessing the severity of OPP in southern Taiwan. A retrospective study was performed on patients admitted with OPP. A total of 75 patients (50 males and 25 females) were studied between January 1996 and December 2005. Diagnosis was based on a clinical assessment and serum acetylcholinesterase (AChE) level at the time of hospital admission. The severity of OPP was assessed using the grading system of Bardin et al. The duration and dosage of atropine and palidroxime were recorded. All the biochemical data were analyzed. Sixty-one of the patients had attempted suicide and 14 patients had accidental exposure. The overall mortality rate was 8%. Muscarinic effects were observed in 66 (88%) of the OPP patients and the most frequent symptom was bronchial hypersecretion (52%). Among these three different severity groups, prolonged length of stay, higher infection rates, and higher mortality were found in the life- threatened group. The initial serum C-reactive protein (CRP) level was strongly correlated to the severity grading of the OPP. Nearly half of the patients were admitted to the intensive care unit (ICU) and, of this, 21 patients developed respiratory failure within 72 hours. Low serum AChE levels support the diagnosis of OPP, but no significant association was found between the severity of OPP and serum AChE levels. The grading system of Bardin et al is very helpful for physicians to facilitate the recognition of seriously poisoned subjects, and to permit their early admission to an ICU. Initial serum CRP, an acute phase reactant, had significant value in assessing the severity of the OPP. Although the management of acute OPP is supportive and the recovery rate is high, anti-cholinergic therapy should be used as soon as possible to counteract muscarinic effects. Physicians must be aware of the potential dangers of respiratory failure, which could occur within 72 hours of OPP. |
| first_indexed | 2024-12-22T05:16:30Z |
| format | Article |
| id | doaj.art-34b94ef2178548328f8898c30039e518 |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-12-22T05:16:30Z |
| publishDate | 2007-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-34b94ef2178548328f8898c30039e5182022-12-21T18:37:50ZengWileyKaohsiung Journal of Medical Sciences1607-551X2007-03-0123311211910.1016/S1607-551X(09)70385-7Organophosphate Poisoning: 10 Years of Experience in Southern TaiwanJong-Rung Tsai0Chau-Chyun Sheu1Meng-Hsuan Cheng2Jen-Yu Hung3Chuan-Sheng Wang4Inn-Wen Chong5Ming-Shyang Huang6Jhi-Jhu Hwang7Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanPoisoning due to organophosphate pesticides is an important cause of morbidity and mortality worldwide. Although standard treatments involving the administration of atropine and oximes have been used, there remain many controversial areas concerning organophosphate poisoning (OPP). Herein, we present our 10 years of experience in assessing the severity of OPP in southern Taiwan. A retrospective study was performed on patients admitted with OPP. A total of 75 patients (50 males and 25 females) were studied between January 1996 and December 2005. Diagnosis was based on a clinical assessment and serum acetylcholinesterase (AChE) level at the time of hospital admission. The severity of OPP was assessed using the grading system of Bardin et al. The duration and dosage of atropine and palidroxime were recorded. All the biochemical data were analyzed. Sixty-one of the patients had attempted suicide and 14 patients had accidental exposure. The overall mortality rate was 8%. Muscarinic effects were observed in 66 (88%) of the OPP patients and the most frequent symptom was bronchial hypersecretion (52%). Among these three different severity groups, prolonged length of stay, higher infection rates, and higher mortality were found in the life- threatened group. The initial serum C-reactive protein (CRP) level was strongly correlated to the severity grading of the OPP. Nearly half of the patients were admitted to the intensive care unit (ICU) and, of this, 21 patients developed respiratory failure within 72 hours. Low serum AChE levels support the diagnosis of OPP, but no significant association was found between the severity of OPP and serum AChE levels. The grading system of Bardin et al is very helpful for physicians to facilitate the recognition of seriously poisoned subjects, and to permit their early admission to an ICU. Initial serum CRP, an acute phase reactant, had significant value in assessing the severity of the OPP. Although the management of acute OPP is supportive and the recovery rate is high, anti-cholinergic therapy should be used as soon as possible to counteract muscarinic effects. Physicians must be aware of the potential dangers of respiratory failure, which could occur within 72 hours of OPP.http://www.sciencedirect.com/science/article/pii/S1607551X09703857acetylcholinesteraseC-reactive proteinorganophosphate poisoning |
| spellingShingle | Jong-Rung Tsai Chau-Chyun Sheu Meng-Hsuan Cheng Jen-Yu Hung Chuan-Sheng Wang Inn-Wen Chong Ming-Shyang Huang Jhi-Jhu Hwang Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan Kaohsiung Journal of Medical Sciences acetylcholinesterase C-reactive protein organophosphate poisoning |
| title | Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan |
| title_full | Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan |
| title_fullStr | Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan |
| title_full_unstemmed | Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan |
| title_short | Organophosphate Poisoning: 10 Years of Experience in Southern Taiwan |
| title_sort | organophosphate poisoning 10 years of experience in southern taiwan |
| topic | acetylcholinesterase C-reactive protein organophosphate poisoning |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X09703857 |
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