Clinico-Toxicological Characteristics of Patients with Acute Organophosphate Intoxication Requiring Mechanical Ventilation

Jin,  Woo Je; Jeong,  Tae Oh; Jin,  Young Ho; Lee,  Jae Baek

J Korean Soc Emerg Med > Volume 15(6); 2004 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2004;15(6): 554-560.

Clinico-Toxicological Characteristics of Patients with Acute Organophosphate Intoxication Requiring Mechanical Ventilation

Woo Je Jin, Tae Oh Jeong, Young Ho Jin, Jae Baek Lee

¹Department of Emergency Medicine, Medical School, Chonbuk National University, Korea. emjin@chonbuk.ac.kr
²Institute of Medical Science, Medical School, Chonbuk National University, Korea.

ABSTRACT

PURPOSE:
The purpose of this study is to investigated the clinico-toxicological characteristics of patients with acute organophosphate intoxication requiring Mechanical Ventilation.
METHODS:
We reviewed retrospectively the medical records of patients with acute organophosphate intoxication in our emergency center from January 2002 to December 2003. We compare to toxicologic characteristics, laboratory findings, patients managements, complications, and outcomes between Mechanical Ventilation group (MV group) and non-Mechanical Ventilation group (non MV group)
RESULTS:
Thirty-six patients are investigated. Twelve patients were the MV group and twenty-four patients were non MV group. In the MV group, patients had more CNS symptoms(83%), higher SAPS II(43.5) and also had abnormal laboratory findings (leukocytosis, high glucose level, high Pco2, and lower pH). Cholinesterase level at presentation was not significant difference between MV group and non MV group, but total amount and administration time of atropine and 2-PAM was significantly different. Respiratory complication and intermediate syndrome were common in the MV group.
CONCLUSION:
We suggest that the patients having CNS and/or nicotinic symptoms following organophosphate intoxication, is a potential patient group requiring intensive care with mechanical ventilation. Additionally we think that hypercarbia due to respiratory weakness or paralysis and mental status change is important factors to decide the application of mechanical ventilation.

Key words: Organophosphate intoxication, Cholinesterase, Mechanical ventilation