Effect of Intensive Atropine Doses (Rapid Incremental Loading and Titration) for Management of Organophosphorus Pesticide Poisoning: a Case Series
Authors
Abstract:
Background:Acute poisoning with organophosphorus (OP) pesticides is a common method of suicide and entails considerable mortality in Bangladesh. The objective of this study was to evaluate the effects and outcomes of a protocol for treatment of OP poisoning that included titrated incremental atropine as loading dose and slow infusion for maintenance. Methods:In this prospective descriptive case series, definitive OP poisoned patients were enrolled in an adult medicine unit of Dhaka Medical College Hospital from April 2006 to April 2007. Clinical examinations were done as soon as the patient entered the ward. Patient’s demographics, comorbid conditions and the occurrence of specific clinical outcomes including death, need for assisted ventilation and clinical complications were recorded. The patients were treated according to the protocol. Results: A total of 56 patients were enrolled over the study period. The median age of the study population was 22.5 years. Most patients were men (67.8%). The most common clinical presentation was miosis (58.9%). In total, 11 patients died (19.6%). Intermediate syndrome developed in 12 patients (21.4%) and 6 of them died. Assisted ventilation was required in 16 cases (28.5). Patients with diastolic blood pressure ≤ 70 mmHg and/or GCS ≤ 10 were significantly less likely to survive (P = 0.02, 0.006, respectively). Moreover, early respiratory failure (P < 0.001) and the need for assisted ventilation (P < 0.001) were significantly higher among deceased cases. The mortality rate in this study was similar to previous studies. The frequency of atropine toxicity in the present study (1.8%) was considerably lower than conventional regimen used in previous studies. Conclusion:Using the new protocol, lower rate of atropine toxicity developed in victims. Hence, the new protocol appears to be safer and its effectiveness should be further evaluated in case control studies in Bangladesh. How to cite this article: Ahmed AS, Basher A, Amin MR, Faiz MA. Effect of Intensive Atropine Doses (Rapid Incremental Loading and Titration) for Management of Organophosphorus Pesticide Poisoning: a Case Series. Asia Pac J Med Toxicol 2014;3:23-6.
similar resources
effect of intensive atropine doses (rapid incremental loading and titration) for management of organophosphorus pesticide poisoning: a case series
background:acute poisoning with organophosphorus (op) pesticides is a common method of suicide and entails considerable mortality in bangladesh. the objective of this study was to evaluate the effects and outcomes of a protocol for treatment of op poisoning that included titrated incremental atropine as loading dose and slow infusion for maintenance. methods:in this prospective descriptive cas...
full textManagement of acute organophosphorus pesticide poisoning
Organophosphorus pesticide self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200,000 people every year. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphorus pesticides are available. Medical management is difficult, with case fatality generally more than 15%. We describe the l...
full textManagement of severe organophosphorus pesticide poisoning
We read with interest the paper by Sungar and Güven [1], which described a case series of organophosphorus pesticide (OP)-poisoned patients managed in their intensive care unit. It clearly demonstrates the difficulty in managing such patients in resource-poor areas [2]. However, we should like to query some issues in their management of OP poisoning and their use of pralidoxime. We cannot under...
full texta comparison of linguistic and pragmatic knowledge: a case of iranian learners of english
در این تحقیق دانش زبانشناسی و کاربردشناسی زبان آموزان ایرانی در سطح بالای متوسط مقایسه شد. 50 دانش آموز با سابقه آموزشی مشابه از شش آموزشگاه زبان مختلف در دو آزمون دانش زبانشناسی و آزمون دانش گفتار شناسی زبان انگلیسی شرکت کردند که سوالات هر دو تست توسط محقق تهیه شده بود. همچنین در این تحقیق کارایی کتابهای آموزشی زبان در فراهم آوردن درون داد کافی برای زبان آموزان ایرانی به عنوان هدف جانبی تحقیق ...
15 صفحه اولthe effect of the utilization of electronic dictionaries on depth and breadth of vocabulary knowledge: a case of iranian efl learners
مطالعه حاضر تلاشی است برای بررسی تأثیرات به کارگیری فرهنگ لغات ، یکی از مهمترین ابزارهای یادگیری واژگان درفراگیری زبان خارجی، بر روی دانش لغوی. دراین تحقیق فرهنگ های الکترونیکی در قیاس با فرهنگ های چاپی مورد بررسی قرارگرفته اند که آیا این فرهنگ ها تاثیرقابل توجهی بر روی دوبعد کمی و کیفی دانش لغوی یعنی عمق و گستره لغات می گذارند. همچنین مشخص گردیده است که آیا تفاوت قابل ملاحظه ای میان عمق و گستر...
15 صفحه اولMy Resources
Journal title
volume 3 issue 1
pages 23- 26
publication date 2014-03-01
By following a journal you will be notified via email when a new issue of this journal is published.
Hosted on Doprax cloud platform doprax.com
copyright © 2015-2023