One Year Cross Sectional Study Of Patients With Organophosphorous Compound Poisoning - Predicting The Need For Ventilator Support

Abstract

Background and objectives Oraganophosphorous compound poisoning is an important indication for emergency ICU admission in most hospitals throughout India. This study has been undertaken to identify the factors which help in predicting the need for ventilator support in patients with organophosphorus poisoning. Methodology The present one year hospital based cross sectional study was done on a total of 100 patients admitted with organophosphorus compound poisoning in the Department of Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2017 to December 2017. On admission clinical examination of the patients was done using POP score and GCS score. Estimation of serum cholinesterase levels was done at the time of admission, on third day and fifth day. Treatment required and the need for ventilator support was predicted with the help of these parameters. Results Maximum number of patients were in age group ≤30 years (30%). There was male preponderance with a M;F of 1.78:1. Poisoning was common with farmers (36%). The most commonly consumed compound was chorpyrifos (24%). Majority of the patients (63%) presented between 3 to 6 hours of consumption. Vomiting and breathlessness were the most common symptoms while miosis, and bradycardia were the commonly observed signs. POP score and GCS score revealed mild intoxication in 54% and 42% of the patients. Majority of the patients (64%) showed an increasing trend of serum cholinesterase. Respiratory failure was the most common complication seen in 8% of the patients. Out of 100 cases, 37% required ventilator support. Mortality was noted in 12% of the patients Conclusion and interpretation There is a statistically significant correlation between POP score, GCS score with ventilator support, with complications and outcome. Serum cholinesterase levels showed significant correlation with ventilator support and outcome (on serial estimation only but not first day levels). Also correlation of time of consumption to arrival at hospital to ventilatory support and correlation of large initial bolus doses of atropine required at arrival to need for ventilatory support was statistically significant.