Life-Saving Resin: Hemoperfusion's Role in Overcoming Acute Organophosphate and Carbamate Poisoning

Abstract

Background: Acute poisoning from organophosphates and carbamates is a major public health concern. These poisons inhibit acetylcholinesterase, leading to severe clinical manifestations. Traditional treatments, such as atropine and oximes, often fall short in severe cases, necessitating alternative therapeutic approaches. Hemoperfusion, an extracorporeal blood purification technique, has shown promise in improving outcomes for poisoning cases. This study aimed to estimate the clinical outcomes of resin-based HOD in individuals with acute organophosphate and carbamate poisoning admitted to a South Asian tertiary care hospital. Methods: A prospective observational study was carried out involving 50 patients diagnosed with acute organophosphate (n=30) or carbamate (n=20) poisoning. Patients underwent standard treatment protocols, and eligible individuals received resin-based hemoperfusion. Data on demographic details, clinical outcomes, complications, and biochemical parameters were collected and analysed using SPSS version 25.0. Results: The study found an overall recovery rate of 84%, with 80% recovery in the organophosphate group and 90% in the carbamate group. The complication rate was 12%, and the mortality rate was 4%. Cholinesterase levels significantly increased post-hemoperfusion, with a mean rise of 600 U/L. Time to treatment was a significant predictor of positive outcomes (p=0.011). Conclusion: Resin-based hemoperfusion is effective in treating acute organophosphate and carbamate poisoning, significantly improving recovery rates and reducing mortality. Early intervention is crucial for optimal outcomes. This treatment modality should be considered a valuable component of poisoning management protocols, especially in resource-limited settings. Recommendations: Further research with larger sample sizes and randomized controlled trials is recommended to confirm these findings and explore additional factors influencing treatment outcomes. Implementation of resin-based hemoperfusion in standard treatment protocols for severe poisoning cases is advised to enhance patient care and survival rates. Keywords: Organophosphate poisoning, Carbamate poisoning, Hemoperfusion, Clinical outcomes