A prospective study on the predictors of mechanical ventilation in organophosphate poisoning

Aravind Varma Datla, Rosaiah Duddu, Pravin Gulab Rao Maske


Background: Organophosphorus poisoning is one of the most common poisonings often requiring ICU care and ventilatory support. The objective and aim of this study are to identify the factors which predict the need for ventilation in these patients.

Methods: 50 patients who were diagnosed to have consumed organophosphorus compound poison admitted in Konaseema Institute of Medical Sciences and Research Foundation who presented within 24 hours of consumption are included in the study. Patients with double poisonings, concomitant illnesses, chronic lung diseases and those treated outside are excluded from the study.

Results: A total number of 50 patients were studied. 18(36%) patients required ventilation. Generalized fasciculations was a discernible feature in 66% of cases in this study. 69.2% of patients with a fasciculation score of ≥4 required ventilation. Ventilation was needed by 55% of patients who had a Glasgow Coma Scale score of ≤10.

Conclusions: Patients who presented with higher fasciculation scores and/or lower GCS scores were more likely to require ventilation. Using GCS scores as a predictor for the requirement of ventilatory support in organophosphate poisoning, a GCS score ten or less was significantly associated with an increased need for ventilatory support.


Fasciculations, Glasgow coma scale, Mechanical ventilation, Organophosphate poisoning, Predictive factors

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Peter JV, Cherian AM. Organic insecticides. Anaesthesia and intensive care. 2000 Feb;28(1):11-21.

Singh S, Sharma N. Neurological syndromes following organophospate poisoning. Neurol India. 2000;48(4):308-13.

Karalliedde L, Senanayake N. Organophosporous insecticide poisoning. Brit J Anaeasth. 1989;63:736-50.

Fernando R. Pesticide poisoning in the Asia-Pacific region and the role of a regional information network. J Toxicol: Clin Toxicol. 1995 Jan 1;33(6):677-82.

Bryan Ballantyne Timothy C. Marrs, Clinical and Experimental Toxicology of Organophosphates and Carbamates Butterworth Hunmann, Oxford publications 1st ed. 1992: Chapter 15;33-37.

Namba T, Nolte CT, Jackrel J, Grob D. Poisoning due to organophosphorous insecticide. Am J Med. 1971;50:475-92.

Steward WC, Anderson Ea. Effects of cholinesterase inhibition when injected into the medulla of the rabbit. J Pharmacol Experim Ther. 1968;162:309-17.

Tsao TC, Jwang Y, Lan R, Sheieh W, Lee C. Respiratory failure in acute organophosphorous and carbamate poisoning. Chest. 1990;98:631-6.

Bardin PG, Van Eeden SF, Joubert JR. Intensive care management of acute organophosphorous compound: a 7-year experience in the west cape. South African Med J. 1987;72:593-7.

Bardin PG, Van Eeden SF. organophosphorous poisoning: grading the severity and comparing treatment between atropine and glycopyrolate. Critical care Medicine. 1990;18:956-60.

Eranaik KB, Nagraj BL. A study of predicting the need for ventilator support and outcome in organophosphorus poisoning. J Evid Based Med Healthc. 2017;4(29):1674-81.

Mutalik GS, Wadia RS, Pai VR. Poisoning by diazinon an organophosphorous insecticide. J Ind Med Associat. 1962;38:67-71.

Singh S, Malhotra V. Parathion poisoning in Punjab (a clinical and electrocardiographic study of 20 cases). J Association of Physicians of India. 1969 Mar;17(3):181-7.

Goel A, Joseph S, Dutta TK. Organophosphate poisoning: predicting the need for ventilatory support. JAPI. 1998 Sep;46(9):786-90.