Department of Emergency Medicine St John's Medical College Hospital, Bangalore
Treatment of organophosphate (OP) poisoning consists of intravenous atropine and oximes. The effectiveness of oxime therapy in OP is still a matter of debate.
To compare the effects of an intermittent dose of pralidoxime chloride versus continuous infusion on the duration of muscle weakness, duration of ventilatory support, intermediate syndrome, duration of hospital stay and eventual outcome.
Inclusion criteria: Unequivocal evidence of OP poisoning, container, Age ≥ 18 years
Exclusion criteria: Inconsistent history of consumption of poison, co-morbid condition like chronic respiratory/cardiac/neurological Illness
52 adult patients presenting to our hospital with a diagnosis of OP poisoning and requiring emergency intensive care were entered in the trial. Patients were randomised using an alternative randomization technique to receive a loading dose of PAM of 1 gm in 100 ml of normal saline over half an hour, followed by a continuous IV infusion of PAM (7mg/kg/hour) for a period of 96 hours from the time of ingestion; (or) Loading dose of PAM of 1 gm in 100 ml of normal saline over half an hour, followed by intermittent PAM injection (1 gm in 100ml normal saline over 1 hour, every 8 hrs) for a period of 96 hours from the time of ingestion. If they are on ventilator or have significant neuromuscular weakness, PAM was to be continued in the same dosage to a maximum of seven days from the time of ingestion. The outcome measures analyzed were mortality, duration of hospital and ICU stays, duration of ventilation, and development of intermediate syndrome.
2003 to 2005.
Will be discussed during the presentation.
