[Evaluation of gastric lavage treatment for severe acute organophosphorus pesticides poisoning complicated by respiratory failure requiring mechanical ventilation].
OBJECTIVE
To discuss the measures of gastric lavage for severe acute organophosphorus pesticides poison (AOPP) patients complicated with respiratory failure and treated with mechanical ventilation.


METHODS
92 cases of respiratory failure due to severe AOPP treated with mechanical ventilation were treated for gastric lavage with nasal gastric tube or gastrotomy. Patients of each gastric lavage method were divided into fasting toxicosis group (fasting group) and post-meal toxicosis group (post-meal group).


RESULTS
When treated for lavage with nasal gastric tube, the duration of coma, the time for reaching atropinization and the dosage of atropine needed, the total dosage of atropine used, the mechanical ventilation time, the time for restoring 50% of the normal value of choline esterase, the hospitalization time and charges, the relapse rate, the rate of atropine toxicosis and mortality were respectively: 13 (3 - 24) h, 180 (60 - 290) min, 150 (80 - 310) mg, 300 (90 - 870) mg, 17 (4 - 52) h, (5.0 +/- 2.3) d, 9 (7 - 18) d, (8080 +/- 2570) yuans, 0, 0, and 4.76% in the fasting groups; all the figures were superior to those of the post-meal group with the same treatment: 26 (4 - 55) h, 380 (110 - 690) min, 360 (90 - 730) mg, 3610 (1100 - 9070) mg, 36 (6 - 110) h, (7.8 +/- 3.6) d, 12 (9 - 35) d, (10 720 +/- 3350) yuans, 45%, 30%, and 30.00% (P < 0.01 or P < 0.05). There was no obvious difference between the fasting group and the post-meal group in curative effect, complication occurrence rate and mortality except for the charges when treated with gastrotomy. For the post-meal toxicosis patients gastrotomy showed a better effect than the nasal gastric tube and there was no difference in charges.


CONCLUSIONS
It is suggested that severe AOPP patients complicated with respiratory failure and treated with mechanical ventilation should hare lavage with nasal gastric tube, if they were poisoned in fasting state, but they should be washed through gastrotomy if poisoned after meal.
Gu
Yong-liang
YL
Department of Intensive Care Unit, Haiyan People's Hospital, Zhejiang 314300, China. gylhyf@hotmail.com
Xie
Wen-jin
WJ
Yao
Liang
L
Lu
Zhi-hua
ZH
D001285:Atropine / Q000008:administration & dosage; D005751:Gastric Lavage / Q000379:methods*; D006801:Humans; D007306:Insecticides / Q000506:poisoning*; D007441:Intubation, Gastrointestinal; D018727:Muscarinic Antagonists / Q000008:administration & dosage; D009946:Organothiophosphorus Compounds / Q000506:poisoning*; D011041:Poisoning / Q000628:therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000628:therapy*
D007306:Insecticides; D018727:Muscarinic Antagonists; D009946:Organothiophosphorus Compounds; D001285:Atropine