English

Abstract

BACKGROUND Organo phosphorous compound poisoning is one of the most common suicidal poisonings in India. The various clinical entities that determine the clinical course and outcome in the ICU of OPC poisoning patient are type of the compound and dose of poison. Delayed presentation and multi-organ failure are some of the major factors that decide the outcome of the patient. This study was conducted to assess the clinical outcome of patients with OPC poisoning on assisted ventilation and assess the various factors that determine the outcome. METHODS A prospective observational study was conducted for a period of 6 months at a government tertiary care hospital in Chennai. All patients with history and clinical signs of OPC poisoning requiring mechanical ventilation for respiratory support were included as our study subjects. Outcome of patients was measured in terms of either recovery or death and factors influencing the outcome such as type of OPC compound, amount consumed, onset and duration of respiratory muscle weakness and pseudocholinesterase levels were considered. RESULTS In the 172 subjects, 108 (62.7 %) patients were successfully extubated from mechanical ventilator and 64 (37.2 %) patients expired. Patients aged more than 40 years, patients who consumed methyl parathion with quantity of poison more than 50 ml, patients with serum cholinesterase levels less than 500, patients who were atropinised for more than 3 days and who were on mechanical ventilation for more than 3 days were the factors found to have a statistically significant association (P < .05) for causing death among patients with OPC poisoning. CONCLUSIONS The mortality among the OPC poisoning patients who were on mechanical ventilation was found to be very high. Early resuscitation of patients with OPC poisoning might reduce the morbidity and mortality. KEYWORDS Organo-Phosphorous Compound Poisoning, Mechanical Ventilation, Clinical Outcome