Fresh Red Blood Transfusion as a Successful Erythrocyte Cholinesterase Supplement in Organophosphate Poisoning

Ying Wang,Zhi Hui Huang

doi:10.4172/2161-0495.1000312

Abstract

Despite improvements to standard treatments (atropine, oxime) and intensive care management, the mortality associated with organophosphate (OP) poisoning has not substantially decreased. In this study, we evaluated the role of packed red blood cells (RBCs) transfusion in acute OP poisoning. Patients diagnosed with OP poisoning were included in this prospective study, and then were transfused with packed RBCs stored less than 10 days or 10 to 35 days. Cholinesterase (ChE) level in blood, atropine usage and durations were recorded. We found both shorter- and longer-storage RBCs (200~400 ml) significantly increased AChE level in blood, improved ChE recovery, and reduced the usage and shortened the duration of atropine and followed clinical recovery. Shorter-storage RBCs had better effect than longer-storage (longer storage) ones. Due to erythrocyte cholinesterase supplement, packed RBCs might be used as an alternative approach in patients with OP poisoning, especially at the early stages.

Highlights

Organophosphorus (OP) compounds are chemical substances that come up with a significant toxicological threat
Acute self-poisoning with organophosphate (OP) pesticides is common in rural Asia, and causes hundreds of thousands of deaths each year [2,3]
To evaluate the role of packed red blood cells (RBCs) transfusion in acute OP poisoning, 60 patients with acute OP poisoning were included in this study

Summary

Introduction

Organophosphorus (OP) compounds are chemical substances that come up with a significant toxicological threat. Acute self-poisoning with organophosphate (OP) pesticides is common in rural Asia, and causes hundreds of thousands of deaths each year [2,3]. OPs inhibit cholinesterase, and lead to the increase and accumulation of endogenous acetylcholine concentration, which affect muscarinic ACh receptors functions mostly in central nervous system, heart muscle, bronchi, alimentary tract and nicotinic ACh receptors in muscular lamina. They exert direct toxic influence on the central nervous system, even could cause death due to pulmonary edema, cerebral edema, respiratory paralysis [4]. We found RBCs transfusion, especially the shorter-storage ones as a supplement of active AChE, could promote ChE restoration, help to improve clinical symptoms

Methods

Results

Conclusion