Study of clinical profile of inhalational organophosphate poisoning at tertiary health care center

 

 

Abstract               Background: Organophosphorus (OP) compound poisoning is the commonest medico-toxic condition in developing countries. The easy and widespread availability of these compounds has increased the likelihood of poisoning. The present study was undertaken with the aim to study the factors affecting outcome of OP compound poisoning and implementing them in the current treatment protocols to prevent complications. Material and Methods: Present study was single-center, prospective, observational study, conducted in patients admitted with history of OP compound consumption or inhalation or accidental spill on clothing in contact with OP Compound OR patients with history of unknown poisoning with confirm clinical features of OP Compound Poisoning. Results: Majority of the patients (61.0%) were in the age group of 21 to 40 years. The age group of 41-60 years had 31 (31.0%) cases. Male patients (73.0%) were more than female patients (27.0%). DM was most commonly used OP agent in 37patients (37.0%) followed by CP 21 (21.0%) and MC among 10 (10.0%) of the cases. The commonest route of exposure was ingestion (96.0%) followed by inhalational route which was observed in 3 (3.0%) of the patients and least common was topical among 1(1.0%) of the cases. Maximum patients reported ICU stay of 5-6 days (68.0%) followed by 17 (17.0%). Fasciculations was the most common clinical feature (71.0%), followed by excess secretions and miosis in 65 (65.0%) each respectively, absent neck holding (22.0%), In present study 18 (18.0%) patients died and 82 (82.0%) of the patients survived. The quantity of OP compound consumed posed an 11 times higher risk of mortality. Conclusion: Mortality was higher cases, present late, delay in initiation of treatment and consumed larger amounts of Organophosphorus compounds. Lower serum cholinesterase levels correlated well with requirement of ventilatory support, increased duration of Intensive care unit stay and outcome.

Keywords: Organophosphorus compounds, serum cholinesterase levels, ventilatory support, intensive care unit, outcome.