Is the World Health Organization-recommended dose of pralidoxime effective in the treatment of organophosphorus poisoning? A randomized, double-blinded and placebo-controlled trial
| Autor: | Khalid Sofi, Showkat Ahmad Gurcoo, Sumaya Syed, Tariq M. Wani, Waqarul Nisa, Ayaz Khalid Farooqui |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Pralidoxime
Double blinded business.industry Organophosphorus Poisoning Mortality rate ventilation atropine Placebo-controlled study Acetyl-cholinesterase pralidoxime Intensive care unit World health law.invention organophosphorous poisoning lcsh:RD78.3-87.3 Atropine Anesthesiology and Pain Medicine law lcsh:Anesthesiology Anesthesia medicine Original Article pseudo-cholinesterase business medicine.drug |
| Zdroj: | Saudi Journal of Anaesthesia Saudi Journal of Anaesthesia, Vol 9, Iss 1, Pp 49-54 (2015) |
| ISSN: | 0975-3125 1658-354X |
| Popis: | Background: Organophosphorus poisoning (OPP) is a major global public health problem. Pralidoxime has been used in a complimentary role to atropine for the management of OPP. World Health Organization (WHO) recommends use of pralidoxime but studies regarding its role have been inconclusive, ranging from being ineffective to harmful or beneficial. Materials and Methods: The present study was undertaken to evaluate the effectiveness of pralidoxime. Eddleston's study was the most compelling factor for our study, as he showed worst outcomes using pralidoxime. Our practice of continuous use of pralidoxime was based on the WHO guidelines and the study by Pawar (2006), which showed better outcome with higher doses of pralidoxime. These conflicting results suggested that a re-evaluation of its use in our clinical practice was indicated. Results: There was no difference in mortality rates, hemodynamic parameters and atropine requirements between the AP and A groups. Mean duration of ventilation (3.6 ± 4.6 in AP group vs. 3.6 ± 4.4 in A group) and Intensive Care Unit stay (7.1 ± 5.4 in AP group vs. 6.8 ± 4.7 in A group) was comparable. Serum sodium concentrations showed a correlation with mortality, with lower concentrations associated with better outcomes. Conclusion: The study suggests that add-on WHO-recommended pralidoxime therapy does not provide any benefit over atropine monotherapy. Adding pralidoxime does not seem to be beneficial and at the same time does not result in increased mortality rates. Our practice changed after completion of this study, and it has proven to be of significant benefit to patients who had to bear the expense of treatment. |
| Databáze: | OpenAIRE |
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