A Retrospective Analysis of Serial Measurement of Serum Cholinesterase in Acute Poisoning with Organophosphate Compounds

Jump To References Section

Authors

  • ,IN
  • ,IN
  • ,IN
  • ,IN
  • ,IN

Keywords:

Mechanical ventilation, organophosphate compound, retrospective analysis, serum acetylcholinesterase levels

Abstract

Objectives: Retrospective analysis of the utility of serial measurements of serum acetylcholinesterase (AChE) in predicting the duration of stay in the intensive care unit (ICU), duration of mechanical ventilation (MV) and outcome of the patient from MV in organophosphate (OP) compound poisoning patients. Materials and Methods: The medical records of patients who presented to tertiary care hospital with symptomatic insecticidal poisoning from January 2009 to December 2010 were utilized for the study purpose. Forty four patients with history of poisoning were admitted during this period. Out of these 37 patients with history of OP poisoning, without any underlying diseases and whose serial AChE activity levels were available were included in the study. Data regarding clinical manifestation at presentation, AChE activity results and its interpretation, details of patient management and data on outcomes of patients were noted. Results: Serum acetycholinesterase levels below 1,250IU/L, 1,789IU/L and 2,764IU/L on day three, day four and five respectively indicates longer duration of stay in the ICU. Patients with serum AChE levels below 975IU/L, 876IU/L, 1,245IU/L, 1,395IU/L and 1,875IU/L on day one, two, three, four and five respectively take a longer time to be out of mechanical ventilation. Levels below 870IU/L, 1,110IU/L, 1,020IU/L and 885IU/L on day two, three, four and five respectively indicate poor prognosis of the patient and mortality. Conclusion: We conclude that the serial measurements of serum acetylcholinesterase levels can be useful in predicting the length of ICU stay, duration of mechanical ventilation and the prognosis of the patient with OP poisoning.

Downloads

Download data is not yet available.

Published

2018-08-14

How to Cite

Manu, M. S., Prashant, V., Akila, P., Suma, M. N., & Basavanagowdappa, H. (2018). A Retrospective Analysis of Serial Measurement of Serum Cholinesterase in Acute Poisoning with Organophosphate Compounds. Toxicology International, 19(3), 255–259. Retrieved from http://informaticsjournals.com/index.php/toxi/article/view/21757

Issue

Section

Original Research
Received 2018-08-14
Accepted 2018-08-14
Published 2018-08-14

 

References

Evtugyn GA, Budnikov HC, Nikolskaya EB. Sensitivity and selectivity of electrochemical enzyme sensors for inhibitor determination. Talanta 1998;46:465-84.

Fukuto TR. Mechanism of action of organophosphorus and carbamate insecticides. Environ Health Perspect 1990;87:245-54.

Bajgar J. Organophosphates/nerve agent poisoning: Mechanism of action, diagnosis, prophylaxis, and treatment. Adv Clin Chem 2004;38:151-216.

Ganesan K, Raza SK, Vijayaraghavan R. Chemical warfare agents.J Pharm Bioallied Sci 2010;2:166-78.

Hasin Y, Avidan N, Bercovich D, Korczyn AD, Silman I, Beckmann JS, et al. Analysis of genetic polymorphisms in acetylcholinesterase as reflected in different populations. Curr Alzheimer Res 2005;2:207-18.

Dyer SM, Cattani M, Pisaniello DL, Williams FM, Edwards JW.Peripheral cholinesterase inhibition by occupational chlorpyrifos exposure in Australian termiticide applicators. Toxicology 2001;169:177-85.

Senanayake N, de Silva HJ, Karalliedde L. A scale to assess severity in organophosphorus intoxication: POP scale. Hum Exp Toxicol 1993;12:297-9.

Taylor P. Anticholinesterase agents. In: Gilman AG, Goodman LS, editors. The pharmacological basis of therapeutics. New York: Macmillan Publishing Co. Inc.; 1985. p. 110-28.

Benmoyal-Segal L, Vander T, Shifman S, Bryk B, Ebstein RP, Marcus EL, et al. Acetylcholinesterase/paraoxonase interactions increase the risk of insecticide-induced Parkinson's disease.

FASEB J 2005;19:452-4.

Ellenhorn MJ, Pesticides, in: M.J. Ellenhorn, editor. Ellenhorn's Medical Toxicology Diagnosis and Treatment of Human Poisoning, second ed., Baltimore, USA: William and Wilkins; 1997, p. 1614-63.

Abdullat IM, Battah AH, Hadidi KA. The use of serial measurement of plasma cholinesterase in the management of acute poisoning with organophosphates and carbamates. Forensic Sci Int 2006;162:126-30.