A review of 62 patients with organophosphate poisoning who were treated at the Iwate Medical University Emergency and Critical Care Center

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  • Yokofuji Hisashi
    Division of Critical Care Medicine Department of Critical Care, Disaster and General Medine, School of Medicine, Iwate Medical University, Yahaba, Japan
  • Fujino Yasuhisa
    Division of Critical Care Medicine Department of Critical Care, Disaster and General Medine, School of Medicine, Iwate Medical University, Yahaba, Japan
  • Fujita Yuji
    Division of Critical Care Medicine Department of Critical Care, Disaster and General Medine, School of Medicine, Iwate Medical University, Yahaba, Japan Poison and Drug Laboratory Division， Critical Care and Emergency Center， Iwate Medical University, Yahaba，Japan
  • Takahashi Gaku
    Division of Critical Care Medicine Department of Critical Care, Disaster and General Medine, School of Medicine, Iwate Medical University, Yahaba, Japan
  • Onodera Makoto
    Department of Regional Emergency Medicine, Fukushima Medical University, Fukushima, Japan
  • Inoue Yoshihiro
    Division of Critical Care Medicine Department of Critical Care, Disaster and General Medine, School of Medicine, Iwate Medical University, Yahaba, Japan

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  • 岩手医科大学高度救命救急センターで治療した有機リン中毒62症例の検討
  • イワテ イカ ダイガク コウド キュウメイ キュウキュウ センター デ チリョウ シタ ユウキ リン チュウドク 62 ショウレイ ノ ケントウ

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Abstract

Atropine for the treatment of organophosphate poisoning inhibits enterokinesis, and prevents gastrointestinal decontamination in some cases. In our department, a treatment method to prioritize gastrointestinal decontamination by intestinal lavage has been performed since 2001. In this study，we retrospectively examined the age, sex, causative substances，initial symptomst, herapeutic strategies, respiratory care, interval until the amelioration of symptoms/laboratory data, and admission period based on medical records of 62 patients with organophosphate poisoning who were treated in our department. In addition, for severe-status patients, the interval until recovery was compared among treatment methods in 24 patients with a minimum serum cholinesterase (ChE) level of ≤ 3 U/L. In the severe-status patients，there were no significant differences in the interval until recovery to a serum ChE level of ≥ 52 U/L (aim of symptom reduction) among the gastric lavage, pralidoxime methiodide, and activated carbon groups. However, the interval was significantly shortened in the intestinal lavage treatment group. There were no significant differences in the tracheal intubation or admission periods among all treatment methods. The results of this study suggested that the duration of symptoms is shortened when intestinal lavage is performed as initial treatment.

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