Details

Autor(en) / Beteiligte

• Hiregoudar, Udayashankar R

Titel

Prediction of Ventilatory Support in Patients with Organophosphorus Poisoning

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2014

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Background and Objectives:India is basically an agricultural country where pesticides and insecticides are abundantly used. Because of the widespread usage and an easier availability for the general population it natural to have these compounds to be misused for suicidal and some instances for homicidal purposes. In the recent years it has been increased to a threatening level and causing a major health challenge. As the major leading cause of death in organophosphate poisoning is respiratory failure, ventilator support for the hospital admitted patients has proven to be most beneficial in saving their lives.Hence the present study was aimed to determine the pseudo cholinesterase, random blood sugar and creatinine phosphokinase levels and to predict the need of ventilator support in these poisoning patients.Methods:50 patients of organophosphorus compound poisoning who met the inclusion and exclusion criteria were selected for this direct observational study. Patient’s history was taken as per the standard proforma. In case of seriously ill or sick patients, history was collected from the patients. Thorough clinical examination and all the necessary investigations were done. Body fluids were collected under aseptic precautions. All the laboratory reports were analysed with proper followup of patients and documentation was done for clinical events. Later the results were analysed using standard statistical methods.Results:The organophosphorus poisoning constituted 56% of total poisoning cases admitted during the study period. The males constituted 58% of cases and females constituted 42% of cases. The vulnerable age group was between 18 to 25 years.94% consumed with intention of suicide whereas 6% of cases were accidental and spraying category. Metacid was the common culprit. Vomiting and pain abdomen were common symptoms while miosis, tachycardia, altered sensorium were common signs.28% patients required assisted ventilation. 64.29% patients were ventilated within first 24 hours..Among 14 patients (14.28%) who required assisted ventilator support, almost all had low levels of pseudocholinesterase levels (P < 0.001) and high levels of both random blood sugar (P < 0.004) and CPK levels (P < 0.003).Patients who were on ventilator support had the longer duration of hospital stay than the patients who were not on ventilatory support. Out of 14 patients who vent on ventilatory support 2 died with 4% of overall mortality rate in the study.Conclusion: The patients in the study group who had decreased levels of pseudocholinesterase levels and increased random blood sugar and CPK levels were more prone for the requirement of assisted ventilation. Hence, in Organophosphosphate poisoning it can be predicted that the patients with low levels of Pseudo cholinesterase and high levels of random blood sugar and CPK may require ventilator support.