Estimation of serum potassium levels as a prognostic marker in acute organophosphorus poisoning in a tertiary care center

Authors

  • Tilottama R. Parate Department of General Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
  • Nitin H. Bhure Department of General Medicine, Indira Gandhi Government Medical College, Nagpur, Maharashtra, India
  • Ramesh U. Parate Department of Radiology, Government Medical College, Nagpur, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20251641

Keywords:

Acetylcholinesterase, Organophosphorus, Respiratory failure, Serum potassium

Abstract

Background: Organophosphorus compound poisoning is primarily a problem of the developing countries. Its widespread use and easy availability have increased the likelihood of poisoning with these compounds. Serum cholinesterase levels are easier to estimate and usually depressed after OP poisoning. Peradeniya OP poisoning scale has not been studied much in Indian scenario. Hypokalaemia is one of the most common electrolyte abnormalities associated with organophosphorus poisoning It could be a simple and effective system to determine the need for ventilatory support early on in the course. The data are scarce especially in central India regarding the OP poisoning and the consequent role of serum potassium in assessing the severity. Hence this study was undertaken to assess the severity of organophosphorus compound poisoning clinically by estimating serum potassium levels.

Methods: A prospective study was performed among 100 cases of OP poisoning, from September 2022 to September 2024. On patient’s fulfilling inclusion criteria were investigated with serum Potassium at the time of admission and estimation of serum acetylcholinesterase were done on the day of admission.

Results: Serum potassium levels were significantly low in subjects who required mechanical ventilation compared to those with normal potassium levels serum potassium levels and Potassium levels were significantly low in patients who developed respiratory failure and thus strongly correlated with clinical severity.

Conclusions: Serum potassium levels show a strong degree of positive correlation with the severity of poisoning and can be used as a predictor of outcome in organophosphorus poisoning.

Metrics

Metrics Loading ...

References

Mogda KM, Kashoury A, Rashed MA. Oxidative and biochemical alterations induced by profenofos insecticide in rats. Nat Sci. 2009;7(2):1-15.

Claudia B. Genotoxicity of pesticides: a review of human biomonitoring studies. Mut Res. 2003;543:251-72. DOI: https://doi.org/10.1016/S1383-5742(03)00015-2

Taylor P. Anticholinesterase agents. In: Goodman and Gilman’s The Pharmacological Basis of Therapeutics. Ed. Hardman J G, Limbird L E, Molinoff P B, Ruddon R W. 9th ed.; 1996:161-76.

World Health Report 2004. WHO, Geneva; 2004. Available at: https://iris.who.int/bitstream/handle/10665/42891/924156265X.pdf. Accessed on 25 March 2025.

Tetzlaff JE, O’Hara JF, Walsh MT. Potassium and anaesthesia. Can J Anaesth 1993;40(3):227-46. DOI: https://doi.org/10.1007/BF03037035

Mount DB. Fluid and electrolyte disturbances. In: Kasper D, Fauci A, Hauser S, et al, eds. Harrison’s principles of internal medicine. Vol. 1. New York: McGraw-Hill Education; 2018:304-306.

Tripathy SK, Rout PK, Debta N. Study of clinical profile of organophosphorus poisoning with special reference to electrocardiographic changes and electrolyte derangement. Int J Adv Med. 2018;5(1):50-6. DOI: https://doi.org/10.18203/2349-3933.ijam20175520

Eyer P. The role of oximes in the management of organophosphorus pesticide poisoning. Toxicol Reviews. 2003;22(3):165-90. DOI: https://doi.org/10.2165/00139709-200322030-00004

Roberts DM, Aaron CK. Management of acute organophosphorus pesticide poisoning. BMJ. 2007;334(7594):629-34. DOI: https://doi.org/10.1136/bmj.39134.566979.BE

Wadia RS, Sadagopan C, Amin RB, Sardesai HV. Neurological manifestations of organophosphorous insecticide poisoning. J Neurol Neurosurg Psychiatry. 1974;37(7):841-7. DOI: https://doi.org/10.1136/jnnp.37.7.841

Gawarammana IB, Buckley NA. Medical management of paraquat ingestion. Br J Clin Pharmacol. 2011;72(5):745-57. DOI: https://doi.org/10.1111/j.1365-2125.2011.04026.x

Difoesa B, Sharma DJ, Hari S. Significance of serum potassium level at admission in organophosphorus poisoning and impact on outcome – a hospital- based study from north east India. J Evid Based Med Healthc. 2021;8(36):3282-7. DOI: https://doi.org/10.18410/jebmh/2021/596

Eddleston M. Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000;93:715–31. DOI: https://doi.org/10.1093/qjmed/93.11.715

He F, Wang S, Tang X, Xia H, Zhao X. Clinical manifestation and diagnosis of acute pyrethroid poisoning. Arch Toxicol. 1989;63(1):54-8. DOI: https://doi.org/10.1007/BF00334635

Adinew GM, Wubie M, Azazh A, Mehta R, Tullu KD. Clinical profile and outcome of organophosphate poisoning patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study. BMC Pharmacol Toxicol. 2017;18(1):35.

Balali- Mood M, Saber H. Recent advances in the t reatment of organophosphorous poisonings. Iran J Med Sci. 2012;37(2):74-91.

Krogager ML, Torp-Pedersen C, Mortensen RN, et al. Short-term mortality risk of serum potassium levels in hypertensive patients: A retrospective cohort study. Eur Heart J. 2017;38(2):104-12.

Brotfain E, Koyfman L, Toledano R. Risk factors associated with the need for mechanical ventilation and mortality in critically ill patients with dyskalemias. Crit Care Resusc. 2017;19(2):143-9.

Downloads

Published

2025-05-30

How to Cite

Parate, T. R., Bhure, N. H., & Parate, R. U. (2025). Estimation of serum potassium levels as a prognostic marker in acute organophosphorus poisoning in a tertiary care center. International Journal of Research in Medical Sciences, 13(6), 2493–2498. https://doi.org/10.18203/2320-6012.ijrms20251641

Issue

Section

Original Research Articles