Title: Predictive Factors for Ventilatory Support in Organophosphorous Poisoning
Authors: Priya Robert, Radha T R
Background and Objectives: The leading cause of death in Organophosphorus poisoning is respiratory failure, which results from a combination of respiratory muscle weakness, central respiratory depression, increased bronchial secretions, bronchospasm and pulmonary edema. A substantial number of deaths can be prevented with timely institution of ventilator support. The present study was undertaken to identify the factors, which help in predicting the need for ventilator support and monitoring in the ICU.
Materials and Methods: 124 consecutive patients of Organophosphorus poisoning admitted to Government medical college, Kottayam, for a period of 10 months were studied. Patients were selected irrespective of age or sex. A provisional diagnosis of Organophosphorus poisoning was made on the basis of a definite history of Organophosphorus poisoning by patient or attenders. This was substantiated by examination of the container, when available. The diagnosis was further substantiated by typical clinical features (hypersalivation, miosis and fasciculations) and characteristic odor of stomach wash or vomitus.
Results: Of 124 patients, 44 required assisted ventilation. The need for ventilator support was significantly more with greater time duration of institution of specific treatment, low level of sensorium at admission, pin point pupils, generalized fasciculations, presence of convulsions and presence of respiratory insufficiency at admission.
Conclusion: The ventilator support in organophosphorus poisoning patients decreases the mortality secondary to organophosphorus related respiratory failure
Keywords: Organophosphorous, Ventilator support.