Human mortality in organophosphate poisonings.
We reviewed 130 admissions of organophosphate poisoning and analyzed the causes of death. Fenitrothion, malathion, dichlorvos, trichlorfon and fenitrothion/malathion were the most frequent chemicals involved. Mortality was 25% (32/130); delay in discovery and transport (18 cases), insufficient respiratory management (8 cases), and severe underlying or co-existing diseases (6 cases) were noted in the lethalities. Insufficient respiratory management consisted of delay in endotracheal intubation (5 cases) and failure in weaning (3 cases). About 3/4 of the severely serum cholinesterase-depressed cases needed ventilators. This suggests that better respiratory management would improve the outcome of organophosphate poisonings. Close observation of the clinical symptoms is essential, and detection of changes in serum cholinesterase may be helpful.
Yamashita
M
M
Department of Emergency and Critical Care Medicine, University of Tsukuba, Japan.
Yamashita
M
M
Tanaka
J
J
Ando
Y
Y
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002800:Cholinesterase Inhibitors / Q000506:poisoning*; D002802:Cholinesterases / Q000097:blood; D004006:Dichlorvos / Q000506:poisoning; D005260:Female; D005278:Fenitrothion / Q000506:poisoning; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D008137:Longitudinal Studies; D008294:Malathion / Q000506:poisoning; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000401:mortality; D012121:Respiration, Artificial; D012189:Retrospective Studies; D016896:Treatment Outcome; D014236:Trichlorfon / Q000506:poisoning
D002800:Cholinesterase Inhibitors; D007306:Insecticides; D004006:Dichlorvos; D014236:Trichlorfon; D002802:Cholinesterases; D008294:Malathion; D005278:Fenitrothion