Predictive Factors of Endotracheal Intubation in Poisoned Patients with Organophosphates

Organophosphates poisoning (OP) is the forth common cause of poisoning and the second cause of death in poisoned patients in Isfahan referral poisoning center. Early diagnosis and appropriate management can reduce both, the complications and mortality. In this study, we determined the predictive factors of endotracheal intubation in patients poisoned by organophosphorus pesticides.

This was a descriptive analysis cross-sectional study. We collected the data of all poisoned patients referred to Noor and Ali Asghar hospital from 2009 June to 2010 October.

In the study period, 43 patients with organophosphate poisoning were evaluated. The prevalence of muscarinic, nicotinic and central nervous system manifestations were 88.4%, 44.2% and 39.5% respectively. Vomiting (55.8%), sialorrhea (41.9%), change in mental status (30.2%), miosis (23.3%), and diaphoresis (23.3%) were the most frequent signs respectively. Overall mortality rate was 13.1%. There was a significant difference in miosis, respiratory distress, bronchorhea, central nervous sign and changes in mental status, and abnormal chest auscultation in endotracheal intubate patients. More than 35 years of age, more than 90 mmHg of diastolic blood pressure, greater than 126 mg/dl blood sugar, change in mental status, abnormal chest auscultation, central nervous system sign, miosis, respiratory distress, and bronchorhea would predict requiring to intubation.

The found predicting factors can help emergency physicians to admit patients with organophosphates poisoning in the intensive care unit (ICU) to reduce mortality and morbidity.