ABSTRACT
Objective: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate [OP] poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature
Methods: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department [ED] or intensive care unit [ICU] of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated. All the data were obtained from electronic and manual patient files. A total of 80 patients were included in the study
Results: The mean age of the study patients was 32.4 +/- 15.0 [13-94]. Forty-nine [61.2%] patients were female. Twenty-two [27.5%] patients were seriously poisoned and needed mechanical ventilation [MV] support. Low pseudocholinesterase [PChE], high creatinine [Cr], low Glasgow Coma Scale [GCS] scores and long hospitalization durations were all found to be poor prognostics in MV patients. Low PChE and high Cr levels were found to be independent predictors of the hospitalization duration and high Cr was found to be an independent predictor of the intubation duration of MV patients in regression analyses. Ten [45.5%] of the MV patients were unresponsive to medical treatment and Therapeutic plasma exchange [TPE] was performed. Seven patients were discharged healthy. Three patients with low PChE levels and comorbidities died
Conclusions: Prolongation of respiratory depression necessitating MV support, comorbidities, long hospital stay, elevated creatinine, low GCS scores and low PcHE levels without regeneration in the first 48 hours of admission are all found to be poor prognostic factors for organophosphate [OP] poisoning
ABSTRACT
We aimed to present inferior vena cava [IVC] diameter as a guiding method for detection of relationship between IVC diameter measured noninvasively with the help of ultrasonography [USG] and central venous pressure [CVP] and evaluation of patient's intravascular volume status. Patients over the age of 18, to whom a central venous catheter was inserted to their subclavian vein or internal jugular vein were included in our study. IVC diameter measurements were recorded in millimeters following measurement by the same clinician with the help of USG both at the end-inspiratory and end-expiratory phase. CVP measurements were viewed on the monitor by means of piezoelectric transducer and recorded in mmHg. SPSS 18.0 package program was used for statistical analysis of data. Forty five patients were included in the study. The patients had the diagnosis of malignancy [35.6%], sepsis [13.3%], pneumonia, asthma, chronic obstructive pulmonary disease [11.1%]. 11 patients [24.4%] required mechanical ventilation while 34 [75.6%] patients had spontaneous respiration. In patients with spontaneous respiration, a significant relationship was found between IVC diameters measured by ultrasonography at the end of expiratory and inspiratory phases and measured CVP values at the same phases [for expiratory p = 0.002, for inspiratory p= 0.001]. There was no statistically significant association between IVC diameters measured by ultrasonography at the end of expiration and inspiration and measured CVP values at the same phases in mechanically ventilated patients. IVC diameter measured by bedside ultrasonography can be used for determination of the intravascular volume status of the patients with spontaneous respiration