title: Butyrylcholinesterase activity-biomarker for predicting the outcome in acute cholinesterase inhibitor poisoning--a 30-year retrospective analysis.
abstract: OBJECTIVE
  To assess the role of butyrylcholinesterase (BuChE) activity as a predictive biomarker in acute cholinesterase inhibitor poisoning in a cohort from a regional tertiary care hospital.
  
  
  METHODS
  Plasma butyrylcholinesterase activity on admission and at regular intervals during admission and clinical outcomes of cases admitted to the Toxicology Clinic of "Sf. Spiridon" Emergency Hospital Iasi, Romania between 1983 and 2013 were evaluated.
  
  
  RESULTS
  A total number of 606 patients were included in the study. The mean BuChE-activity level on admission was 1.54 ml NaOH N/100. A correlation between the amount of ingested organophosphates/carbamates (OPs/CMs) and low cholinesterase activity on admission was found. 66.66% of the patients were admitted to hospital within 8 hours after poisoning. The initial, daily and mean total atropine doses administrated were 9.65 mg, 10.51 mg and 69.39 mg, respectively. 67.16% of the investigated patients received Toxogonin for 6.41 days showing a slow increase in BuChE activity afterwards. The average number of hospital days was 11.22. The study revealed that complications occurred in patients with BuChE-activity levels below 1.4 mL NaOH N/100. A positive correlation between mortality rate (3.8% of patients) and the lowest BuChE-activity level on admission (0.89 mL NaOH N/100) was found.
  
  
  CONCLUSIONS
  BuChE activity on admission and its level during hospital stay represent an important predictive factor for acute cholinesterase inhibitors poisoning.
authors.affiliation: University of Medicine and Pharmacy Grigore T. Popa - Iaşi, Department of Medical Specialties (I).
authors.forename: E N
authors.initials: EN
authors.lastname: Gazzi
authors.forename: Victoriţa
authors.initials: V
authors.lastname: Sorodoc
authors.forename: O
authors.initials: O
authors.lastname: Petris
authors.forename: Liliana
authors.initials: L
authors.lastname: Tarţău
authors.forename: Gabriela
authors.initials: G
authors.lastname: Dumitrescu
authors.forename: L
authors.initials: L
authors.lastname: Sorodoc
authors.forename: Cătălina E
authors.initials: CE
authors.lastname: Lupuşoru
mesh_terms: D001285:Atropine / Q000008:administration & dosage / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002091:Butyrylcholinesterase / Q000097:blood*; D002800:Cholinesterase Inhibitors / Q000097:blood / Q000506:poisoning*; D002801:Cholinesterase Reactivators / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006785:Hospitals, University; D006801:Humans; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D009768:Obidoxime Chloride / Q000008:administration & dosage / Q000627:therapeutic use*; D062025:Organophosphate Poisoning / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D002800:Cholinesterase Inhibitors; D002801:Cholinesterase Reactivators; D018727:Muscarinic Antagonists; D009768:Obidoxime Chloride; D001285:Atropine; D002091:Butyrylcholinesterase