[Clinical feature of organophosphate poisoning patients requiring prolonged mechanical ventilation]

To clarify the clinical characteristics in organophosphate poisoning patients who require prolonged mechanical ventilation (PMV).

We reviewed the medical records of 15 adults organophsophate poisoning patients who admitted to our intensive care unit between Junuary, 1995, and December, 2004. The patients were divided into two groups: a PMV group requiring mechanical ventilation for more than 1 week (n=7) and a non PMV group (n=8), and various factors relating to PMV were compared between the two groups.

The mean value of mechanical ventilation days was 16 +/- 6 days for the PMV group, which was significantly greater than 1 +/- 1 days for the non PMV group (p < 0.01). There were no statistical differences in the physical findings such as Japan Coma Scale, vital signs, and salivation and/or diarrhea, and in the treatments such as gastric lavage, administration of activated charcoal, and intravenous administration of pralidoxim and/or atropine on admission between the groups. The intermediate syndrome developed in 5 patients of the PMV group during their hospital course, whereas in no patient of the non-PMV group (p < 0.05). Hospital length of stay was 35 +/- 7 days in the PMV group, comparing with 11 +/- 11 days in the non-PMV group (p < 0.01). All patients of both groups survived and all but one patient returned to pre-hospital activities of daily living.

Organophosphate poisoning patients requiring PMV had a higher incidence of the intermediate syndrome, but had similar mortality and morbidity compared with patients without PMV.