One year-study of patients with acute organophosphate insecticide poisoning admitted to the intensive care unit of Hamad General hospital, Doha, State of Qatar

ABSTRACT

Organophosphate poisoning continues to be one of the important problems of poisoning presenting to the intensive care unit. To describe the clinical course, diagnosis, out come of acute organophosphate [OP] insecticide poisoning and to review the management measures taken in intensive care unit [ICU]. Descriptive prospective observational study. Intensive Care Unit of Hamad General Hospital, State of Qatar. Patients with acute OP poisoning admitted to the ICU from 1st January to 31st December 2005. Eight patients were admitted to the ICU; six males and two females. Seven had accidental exposure, while one was attempted suicide. The majority of patients exhibited the classic clinical features of patasympathetic overactivity. No patient had features of intermediate syndrome or Organophosphate Induced Delayed Neuropathy [OPIDN]. All patients received atropine, while pralidoxime was given to only 6 patients. Mechanical ventilation was required in 3 patients for respiratory failure, with mean ventilation duration of 2.3 +/- 1.5 days. No mortalities were recorded. The widespread use of organophosphates as a household and agricultural pesticide, in the absence of adequate regulations and education in their use is probably the most important reason for OP poisoning in a non-agricultural country like Qatar. Despite severe toxicity in most of our cases, there were nofatalities. This reflects the necessity of early diagnosis, treatment and the implementation of advanced supportive care in ICU