Title: Electrolyte Derangements as a Prognostic Marker in Acute Organophosphorus Poisoning
Authors: Dr Karthik M.R, Prof. Dr S. Balasubramaniyan, M.D., Dr N.Paari, M.D.
DOI: https://dx.doi.org/10.18535/jmscr/v8i11.79
Abstract
Background: Organophosphorus compounds (OPC) are one of the common causes of poisoning in rural India. Although serum cholinesterase is used to diagnose OP compound poisoning, it is not a reliable marker in prognostication of OP poisoning. This study is done to analyze the role of serum electrolytes in assessing the prognosis of OP poisoning.
Aim: To estimate the serum electrolytes in patients, who consumed organophosphorus compound (OPC) and to determine its role in prognosis.
Materials and Methods: This is a prospective cross-sectional study. Seventy patients who have consumed OPC, admitted in Rajah Muthiah Medical College and Hospital were selected, with age of eighteen years and above. They were chosen regardless of the type of exposure and sex and were subjected for study. Assessment of patients was done clinically by Peradeniya OPC Poisoning scale and then patients were categorized based on severity. Serum electrolytes were estimated at the time of admission.
Results: Out of 70 patients in the study, 56 were male (80%) and 14 were female (20%) with male:female ratio of 4:1. Majority of patients belong to the age group between 18 and 30 years. Monocrotophos was the commonly consumed poison in this study and most patients presented with moderate clinical severity, graded based on peradeniya OP poisoning scale. Hypokalemia was the common electrolyte derangement observed in the study and it significantly correlated with increased ventilator requirement and mortality in OPC poisoning.
Conclusion: It was concluded from this study that hypokalemia contributes significantly to the ventilator requirement and outcome in OPC poisoning. Routine measurement of serum potassium should be done, as it can be a cost-effective and reliable marker and will be helpful in prognostication and predicting the outcome in OPC poisoning. Aggressive correction of hypokalemia can be a life saving measure in these patients.
Keywords: Organophosphorus compound poisoning, hypokalemia, prognosis.
