Study of acid base imbalance in organophosphorus poisoning in intensive care patients of eastern Gujarat tribal region

Abstract

Organophosphorus (OP) pesticides poisoning can result from occupational, accidental or intentional exposure. The compounds can be absorbed through skin, conjunctiva, oral mucosa, GI tract or respiratory tract. This study aimed to analyze arterial blood gas (ABG) analysis and serum cholinesterase (SC) activity in OP poisoning, to study clinical correlation of OP poisoning with the help of ABG analysis and SC and to compare factors of OP poisoning patients and control group. A total, 156 OP poisoning cases and 156 control participants were included in this study. The ABG and SC sample was processed at Central Clinical Biochemistry Laboratory, Medical College and Hospital, in a tertiary health care in eastern Gujarat. Most of the OP poisoning cases were young people 80% (<50 years of age) with mean±SD age as 26.41±11.28 years (range: 11-80). Among these 90(57.69%) and 66(42.31%) were females and males respectively. While control participants with mean±SD age as 29.97±15.75 (range: 15-85) and male were 103(66%) and 53(34%) were females. Significant difference was found out between the age, Electrolytes: Na+, K+, Cl- and SC (p<0.001), mean SC level in patients with the latent grade of poisoning was 1363.24±1326.76 IU/L, which is clinically significant (p<0.001), no significant difference found between pH, pCO2, pO2, HCO3act and HCO3std (p>0.05). This study concluded that mortality is directly proportionate to the amount of OP substances consumed, clinical severity of poison, SC levels, ABG analysis and electrolytes level in blood. This study can be improving survival or reduces mortality in patients with organophosphorus insecticide poisoning.