Organophosphate poisoning Injury, Occupational Diseases, Poisoning Toxic effect of pesticides
Conditions
Interventions
Treatment arms:
1. Fresh frozen plasma (FFP) (250 ml/bag): 4 bags on day 1 then 2 bags on day 2 and 3
2. 20% human albumin: 200 ml intravenous on day 1 then 100 ml on day 2 and 3
3. Control: do not
Sponsors
South Asian Clinical Toxicology Research Collaboration (SACTRC) (Sri Lanka)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Patients (both males and females) above 15 years who present to the Emergency Department of Christian Medical College and Hospital (CMCH) with a diagnosis of organophosphate poisoning made on the basis of: 1. The typical clinical toxidrome of cholinergic and nicotinic manifestations 2. Reliable identification of the compound ingested based on the container brought by patient attendants or a subsequent confirmation by serum pseudocholinesterase levels of less than 1000 IU/L
Exclusion criteria
Exclusion criteria: 1. Those who present more than 12 hours after having consumed the OP poison ("late presenters") 2. Those who are suspected to have taken a combination of poisons/tablets along with the OP ("poly-substance overdose") 3. Those who are already treated with oximes in other hospitals prior to coming here ("prior oxime therapy"). This is because we do not want to have more than one intervention which can affect outcomes. 4. Those who are pregnant or lactating 5. Those who do not give consent for the study 6. Those who have a pre-existing volume overloaded state 7. Those who have a cardiac arrest within 15 minutes of arrival in the emergency department
Design outcomes
Secondary
| Measure | Time frame |
|---|---|
| All measured during hospital stay and determined at discharge: 1. Reduce the need for invasive mechanical ventilation 2. Reduce mortality 3. Decrease Intensive Care Unit (ICU)/hospital length of stay 4. Reduce the duration of ventilation 5. The total dose of atropine required (daily and cumulative) 6. Temporal profile of organophosphate levels (total and functional), serum butyrylcholinesterase (BuChE) level 7. Adverse events and transfusion reactions | — |
Primary
| Measure | Time frame |
|---|---|
| 1. Lower the incidence of intermediate syndrome, measured during hospital stay and determined at discharge 2. Reduce effective circulating organophosphate levels, assayed directly and functionally and measured directly after the infusion of trial or placebo interventions | — |
Countries
India
Outcome results
None listed