The correlation of serum cholinesterase and clinical signs in acute organophosphate poisoning

30 acute organophosphate poisoning patients admitted in our department were classified into three groups of severity based on serum cholinesterase level and clinical syndromes of cholinergic crisis. Atropine was given at dose of 2-5mg every 10-15 minutes until the atropinisation reached then the doses of atropine were adjusted to maintain it. Pralidoxime was administered according to severity and its dosages were titrated as serum cholinesterase levels and clinical changes. Data was analyzed by SPSS for Windows. (1) The patients had good outcome with short duration of hospitalization (5.73.8) and low mortality (3.3%). (2) Serum cholinesterase was correlated with number of clinical symptoms (r=-0.613); clinical score (r=-0.580); number clinical syndromes (r=-0.515); total dose of atropine (-.714) severity of poisoning (r=-0.928) and total dose of PAM (r=-0.721). All correlation was significantly at the 0.01 level. (3) Total dose of PAM was correlated with clinical symptoms (r=0.625); clinical score (r=0.596); clinical syndromes (r=0.658); severity of poisoning (0.695); duration of hospitalization (0.889)

Titrate pam dosage according to serum cholinesterase level in the management of acute organophosphate poisoning

20 patients hospitalized from 1998 to 2000 due to acute organophosphate poisoning were treated by intravenous infusion of PAM at dose of 0.25g - 1g per hour. The dosage of PAM was adjusted according to concentrations of serum cholinesterase tested every 12 hours. The results of study showed that the clinical status was significantly improved: in-hospital stay time was shorter, dose of atropine was lower, severe complications such as paralysis, respiratory failure were decreased in comparison to previous studies. Thus, the level of serum cholinesterase is correlated to poisoning severity and is good indicator for adjustment of PAM dosage in the management of acute organophosphate poisoning.