The role of lipid emulsion in organophosphorus pesticide poisoning in clinical practice

Abstract

Introduction: A major clinical and important for the public health issue causing many deaths is acute organophosphorus pesticide (OP) poisoning. The clinical behaviour during these cases of intoxication has improved slightly in recent years, but the same two antidotes are still used—atropine and oximes, as well as the standard resuscitation and detoxification methods. There are many experiments and clinical cases that demonstrate the benefit of lipid emulsions (LEs) in cases of intoxication with lipophilic agents, as well as with pesticides. Case Presentation: A retrospective study has been performed on 20 patients with cases of acute exogenous pesticide intoxication. An intravenous LE was administered to four of them as an add-on therapy to the main therapeutic regimen. Results: A quantitative assessment of consciousness was made—the majority of patients entered the hospital in a severe condition, the state of consciousness of 3 patients receiving LE (75%) was defined as obnubilation and one patient (25%) was in a coma. In LE-free control cases, the most common complications were exotoxic shock (37.5%), acute respiratory failure (31.25%), and arterial hypotension (31.25%). In the patient control group, the mortality was 50% (8 cases), and in those treated with LE, 1 patient died (25% of cases). Conclusion: Based on these clinical data, we believe that lipid emulsion can be useful in the treatment of intoxication with acute exogenous pesticides as an add-on to antidote therapy.