Objective: To explore the clinical characterist ics and risk factors of hemorrhage complicated by hemoperfusion therapy in patients with acute poisoning. Methods: In January 2021, the clinical data of 196 patients with acute poisoning who received hemoperfusion therapy in the Second Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2020 were analyzed, and the patients were divided into bleeding group and non-bleeding group according to whether the patients were complicated with bleeding. Multivariate logistic regression was used to analyze the independent risk factors for hemorrhage in patients treated with hemoperfusion. Results: A total of 21 patients in the bleeding group and 175 patients in the non-bleeding group were included. There was no significant difference in general data such as gender, age, and body mass index between the two groups (P>0.05) . Organophosphorus pesticides (χ(2)= 4.56, P=0.030) , HA230 perfusion device (χ(2)=4.12, P=0.042) , platelet count (t=-2.33, P=0.009) and activated partial thromboplastin time (t=14.53, P<0.001) at 2 h of perfusion were the influencing factors of hemorrhage in patients with acute poisoning treated with hemoperfusion. Among them, organophosphorus pesticides, 2 h perfusion activated partial thromboplastin time ≥35 s and other factors were independent risk factors forcomplicated bleeding (P<0.05) . Conclusion: Patients with acute poisoning, especially organophosphorus pesticide poisoning, are at greater risk of bleeding during hemoperfusion therapy. Monitoring of changes in activated partial thromboplastin time should be strengthened and the dose of anticoagulants should be adjusted in time to reduce the risk of bleeding.
Hemoperfusion ; Hemorrhage/therapy* ; Humans ; Organophosphorus Compounds ; Pesticides ; Poisoning/therapy* ; Risk Factors

OBJECTIVETo investigate the clinical effect of hemoperfusion combined with hemodialysis in the treatment of severe organophosphate pesticide poisoning.

METHODSNinety-eight patients with severe organophosphate pesticide poisoning who were admitted to the emergency department of our hospital from March 2005 to September 2013 were equally divided into control group and observation group according to treatment methods. The control group was given conventional emergency treatment, while the observation group was given hemoperfusion combined with hemodialysis and the conventional emergency treatment. The clinical outcomes and complications of two groups were compared.

RESULTSIn the control group, 35 patients were cured and 14 patients died, so the cure rate was 71.4%. In the treatment group, 46 patients were cured and 3 patients died, so the cure rate was 93.9%. The treatment group had a significantly higher cure rate than the control group (χ² = 8.611, P < 0.05). And the treatment group had significantly shorter duration of coma (P < 0.01), mean length of hospital stay (P < 0.01), and time to recovery of cholinesterase activity (P < 0.01) and a significantly reduced dose of atropine than the control group (P < 0.01). The control group had significantly more cases of urinary retention than the treatment group (18 vs. 6, χ² = 4.991, P < 0.05). And the control group had more cases of intermediate syndrome, respiratory failure, delayed neurological damage, and rebound than the treatment group.

CONCLUSIONHemoperfusion combined hemodialysis has a good clinical effect and causes fewer complications in treating severe organophosphate pesticide poisoning, so it is worthy of clinical promotion.

Atropine ; Hemoperfusion ; Humans ; Insecticides ; poisoning ; Organophosphate Poisoning ; therapy ; Organophosphates ; Organophosphorus Compounds ; Renal Dialysis ; Time Factors

BACKGROUND/AIMS: Organophosphate poisoning has a high mortality rate. Recently, differences among organophosphorus insecticides in human self-poisoning were reported. This study investigated the prognostic risk factors and the mortality of different organophosphates following acute organophosphate poisoning. METHODS: This retrospective study included 68 patients with acute organophosphate poisoning. We investigated patient survival according to initial parameters, including the initial Acute Physiology and Chronic Health Evaluation (APACHE) II score, serum cholinesterase level, and hemoperfusion and evaluated the mortality according to organophosphate types. RESULTS: Thirteen of the 68 patients died. The agents responsible for mortality were different. The APACHE II score was a significant predictor of mortality (odds ratio [OR], 1.194; p<0.01; 95% confidence interval [CI], 1.089 to 1.309) and respiratory failure (OR, 1.273; p<0.01; 95% CI, 1.122 to 1.444). The mortality was 0% for dichlorvos, malathion, chlorpyrifos and profenofos. However, other organophosphates showed different mortality (16.7% for O-ethyl-O-4-nitrophenyl phenylphosphonothioate, 25% for phenthoate, 37.5% for phosphamidon, 50% for methidathion). The usefulness of hemoperfusion appears to be limited. CONCLUSIONS: The initial APACHE II score is a useful prognostic indicator, and different organophosphates have different mortality.
APACHE ; Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cholinesterases/blood ; Female ; Humans ; Male ; Middle Aged ; Organophosphorus Compounds/*poisoning ; Poisoning/mortality ; Prognosis ; Retrospective Studies

Adolescent ; Adult ; Atropine ; therapeutic use ; Female ; Foodborne Diseases ; drug therapy ; Humans ; Insecticides ; poisoning ; Male ; Muscarinic Antagonists ; therapeutic use ; Organophosphorus Compounds ; Pesticide Residues ; poisoning ; Pesticides ; poisoning ; Treatment Outcome

Adult ; Atropine ; therapeutic use ; Bronchodilator Agents ; therapeutic use ; Combined Modality Therapy ; Female ; Hemofiltration ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Organophosphorus Compounds ; Poisoning ; therapy ; Treatment Outcome

Acute Disease ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China ; Humans ; Infant ; Inpatients ; Insecticides ; poisoning ; Middle Aged ; Organophosphorus Compounds ; Pesticides ; poisoning ; Poisoning ; etiology ; mortality ; therapy ; Risk Factors ; Survival Rate

OBJECTIVETo explore the association of gene polymorphism of organophosphate insecticides (OPs) metabolic enzymes with intermediate myasthenia syndrome (IMS) following acute OPs poisoning.

METHODSThirty six of 147 acute OPs poisoning patients developed IMS one to four days after poisoning. Peripheral blood samples were collected from all the patients and whole blood cholinesterase (ChE) activity was determined by DTNB spectrometry. The genetic polymorphism of CYP2E1 (1091C-->T) and GSTP1 (313A-->G) were analyzed by polymerase chain reaction (PCR)-restrict fragment length polymorphism, CYP1A1 (4889A-->G), GSTM1 and GSTT1 by allele-specific PCR, and PON1 at 55 codon (55L-->M) by PCR-single strand conformation polymorphism.

RESULTSThe whole blood ChE activity in IMS patients was not significantly different from non-IMS patients at admission (38.22 +/- 17.56)% and (42.49 +/- 16.23)%, respectively, P > 0.05, but recovered much slower in IMS patients than that in non-IMS patients. The frequencies of heterozygote and variant homozygote of PON1 at 55 codon, GSTM1 null, and both GSTM1 and GSTT1 null were higher in IMS patients than those in non-IMS patients (P < 0.05), with odds ratios and their 95% confident intervals of 2.48 (1.06 - 5.78), 11.23 (2.95- 42.76), 2.53 (1.14 - 5.61) and 2.68 (1.20 - 5.97), respectively.

CONCLUSIONSPatients of OPs and its mixture poisoning with genotype of variant allele at 55 codon of PON1, GSTM1 null and both GSTM1 and GSTT1 null probably had higher risk for IMS.

Adult ; Cholinesterases ; metabolism ; Cytochrome P-450 CYP2E1 ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Glutathione Transferase ; genetics ; Homozygote ; Humans ; Insecticides ; poisoning ; Male ; Middle Aged ; Myasthenia Gravis ; chemically induced ; genetics ; Organophosphorus Compounds ; Point Mutation ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Syndrome

Acute Disease ; Adolescent ; Adult ; Apolipoprotein A-I ; blood ; Apolipoproteins B ; blood ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Female ; Humans ; Insecticides ; poisoning ; Lipids ; blood ; Lipoproteins ; blood ; Male ; Middle Aged ; Organophosphorus Compounds ; Poisoning ; blood ; Triglycerides ; blood

OBJECTIVETo study the new method of monitoring and clearing organophosphate in blood during single or mixed organophosphate(OP) poisoning.

METHOD(1) Mixed equal volumes of blood of OP poisoned rat and healthy rat, then determine whole blood cholinesterase (ChE) activity. The descending range of ChE activity represents the level of residual OP in blood. (2) Poisoned rats by single or mixed OP pesticides were injected with 5% NaHCO3 15 ml/kg intraperitoneally, then the level of OP in blood was detected.

RESULTS(1) The monitoring results of blood residual OP by gas chromatography were similar to that by "Mixes blood method", which showed significant difference(P < 0.05) from that before OP administration. (2) NaHCO3 injection could not improve the toxic symptoms and whole blood or brain ChE inhibition in 10 CP poisoned rats, blood residual OP level was also not affected, but lung pathological changes by OP such as interstitial inflammation and oedema showed some relief.

CONCLUSIONThe monitoring of blood ChE by "mixed blood method" may reflect the general level of the blood residual OP within the range of exposure dose. The effect of NaHCO3 was not satisfactory, but it may improve OP-induced lung pathological changes.

Animals ; Cholinesterase Inhibitors ; poisoning ; Cholinesterases ; blood ; Chromatography, Gas ; Insecticides ; poisoning ; Lung ; pathology ; Organophosphate Poisoning ; Organophosphorus Compounds ; blood ; Rats ; Sodium Bicarbonate ; pharmacology

BACKGROUND: Although glyphosate, organophosphorus herbicide, has been used extensively in agricultural area, no clinical data of acute poisoning have been reported in Korea. The current study evaluated clinical characteristics of acute intoxication by glyphosate. METHODS: We retrospectively collect and analysed the clinical data of 16 acute glyphosate poisoned patients admitted to the department of internal medicine, Soonchunhyang University Chunan hospital from January 1999 through June 2000. RESULTS: 1) Thirteen of sixteen poisoning were male and mean age was 44.2 year-old. 2) The main cause of glyphosate ingestion was suicide intent (12 cases, 75%), and clinical severity was divided into 3 categories : mild (14 cases), moderate (1 case) and severe (1 case). 3) Nausea and vomiting were the most frequent clinical features (each 6 cases) and dyspnea (4 cases), cough (3 cases), sputum (3 cases) and sore throat (3 cases) were followed. Leucocytosis, hepatotoxicity, anemia, hypoxia and renal toxicity were observed in 9,8,5,6 and 3 cases, respectively. 4) No fatal case and severe complication, except 1 aspiration pneumonia and 1 acute respiratory failure, were observed in acute glyphosate poisonings. CONCLUSION: Our data supported that acute glyphosate poisoning dose not result in fatal in humans even after intentional ingestion of glyphosate.
Anemia ; Anoxia ; Chungcheongnam-do ; Cough ; Dyspnea ; Eating ; Herbicides ; Humans ; Internal Medicine ; Korea ; Male ; Nausea ; Organophosphorus Compounds ; Pharyngitis ; Pneumonia, Aspiration ; Poisoning ; Respiratory Insufficiency ; Retrospective Studies ; Sputum ; Suicide ; Vomiting