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Respiratory Failure Following Organophosphate Poisoning: A Literature Review

Pirthvi Raj Giyanwani1, Ujala Zubair2, Osama Salam3

  • 1Civil Hospital Karachi, Dow University of Health Sciences (DUHS), Karachi, Pakistan.

Cureus
|November 17, 2017
PubMed

Insights

Organophosphate poisoning causes respiratory failure, often requiring ventilation. Future treatments should focus on protecting the central nervous system (CNS) to improve outcomes for patients with organophosphate toxicity.

Area of Science:

  • Toxicology
  • Emergency Medicine
  • Neuroscience

Background:

  • Organophosphates (OPs) are a leading cause of global suicides.
  • OP poisoning causes cholinergic crises, leading to respiratory failure.
  • Respiration inhibition involves both central and peripheral mechanisms, with central effects predominating.

Purpose of the Study:

  • To review the literature on acute organophosphate poisoning in humans.
  • To analyze the incidence of ventilatory support in OP poisoning patients.
  • To identify potential future treatment strategies for OP poisoning.

Main Methods:

  • Literature search conducted in June 2017 using PubMed, Embase, and Google Scholar.
  • Included studies published between 2001 and 2016 reporting acute organophosphate poisoning in humans.
  • Data collected from 1,996 patients with organophosphate poisoning.

Main Results:

  • Nearly a quarter of patients (24.6%) required ventilatory support due to respiratory failure.
  • Central nervous system mechanisms are predominant in OP-induced respiratory inhibition.
  • The study highlights the critical need for respiratory support in severe cases.

Conclusions:

  • Treatment for organophosphate poisoning should target its underlying pathophysiology.
  • A central nervous system (CNS) protective strategy is crucial for future prevention and treatment.
  • Improving outcomes necessitates a focus on managing cholinergic crises and respiratory compromise.
Keywords:
clinical trialsorganophosphate poisoningrespiratory failure

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