Intensive therapy for chloroquine poisoning. A review of 29 cases.
OBJECTIVE
To obtain a data base of the features of chloroquine poisoning and to assess existing intensive therapy for it.


METHODS
Retrospective review of all confirmed cases of acute chloroquine poisoning admitted to intensive care between November 1990 and October 1994. All available records were scrutinised.


METHODS
The intensive care units of Harare Central and Parirenyatwa hospitals, which are referral centres in Harare.


METHODS
Selection of patients depended on positive confirmation of chloroquine ingestion. Cases of concomitant ingestion of other drug(s) were not excluded.


METHODS
Cardiac arrest or not; death or survival to discharge from hospital.


RESULTS
Of a total of 29 patients, aged 16-51 years, 69% (20) were female and 31% (9) male. The commonest clinical features were respiratory failure, depressed level of consciousness, hypothermia, hypotension, cardiac arrest and hypokalaemia. Eleven patients had at least one cardiac arrest; 5 of these were successfully resuscitated. Management included gastric lavage, intravenous diazepam, mechanical ventilation when necessary, and occasionally inotropic infusions. Four patients suffered cardiac arrest during gastric lavage. There were 6 deaths (mortality 20.7%).


CONCLUSIONS
This study indicates the common clinical features of acute chloroquine poisoning. A survival rate of about 80% is being achieved by intensive therapy at Harare Central and Parirenyatwa Hospitals. Rapid utilisation of the treatment regimen described should reduce the mortality to less than 10%.
Division of Anaesthetics, Parirenyatwa Hospital, Harare, Zimbabwe.
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AG
McKenzie
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000962:Antimalarials / Q000493:pharmacokinetics / Q000506:poisoning; D002738:Chloroquine / Q000493:pharmacokinetics / Q000506:poisoning; D016208:Databases, Factual; D003975:Diazepam / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000188:drug therapy / Q000401:mortality; D012121:Respiration, Artificial; D012189:Retrospective Studies; D015996:Survival Rate; D015030:Zimbabwe
D000962:Antimalarials; D002738:Chloroquine; D003975:Diazepam