Hossein Hassaniam-Moghaddam, Neda Baghbanian, Ali Ashghar Kolah,
Volume 1, Issue 2 (6-2007)
Abstract
Introduction: Iran is a young-populated country. Loss of consciousness (LOC) due to poisoning is a major cause of patients' referrals to emergency departments. It has good prognosis if it is appropriately diagnosed and treated.
This study was done to determine the causes of LOC in patients hospitalized in poisoning ICU of Loghman-Hakim Poison Hospital (LHPH) from September 23, 2004 to March 20, 2005.
Materials and Methods: This descriptive study was performed on 263 poisoned patients in the poisoning ICU of LHPH who had LOC with advanced grades (2,3 or 4) and were 10 years and older. Questionnaires including these data were filled: age, sex, grade of LOC, cause of LOC, cause of using the drug or poison (accidental or suicidal) and the outcome. These questionnaires were filled for patients whose data met our inclusion criteria. All the information was then analyzed by SPSS using Chi-square test.
Results: Two hundred sixty three patients were studied of which 59.7% were men and 40.3% women. The mean age was 30.2±11.9 with the range of 11 to 76 years. The median age was 26. The most common age group was 21 to 30 (45.3%). The most common causes of LOC were tricyclic antidepressants (TCAs) (26%), opium and opioids (18.6%), benzodiazepines (15.43%), unknown etiology (9.7%) and organophosphates (7.7%). 23.6% were poisoned accidentally and 76.4% were poisoned due to suicide attempts. Finally, 81.4% were discharged and 18.6% died.
Conclusion: Most poisonings were due to suicides and the most common age was that of young people. Therefore, it is recommended that the young be mentally supported so that the suicidal motives decrease. Most comatose cases due to poisoning eventually recovered fully.
Bahareh Sepehrian,
Volume 5, Issue 12 (9-2011)
Abstract
Background: Our aim was to evaluate the effect of intravenous intralipid administration as an antidote on the poisoned patients' Glasgow Coma Scale (GCS), hemodynamic parameters, arterial blood gas analysis, and routine metabolic profile tests (i.e. urea, glucose, sodium, and potassium) in the setting of non-local anesthetic drug overdose.
Methods: In this randomized controlled trial, a total of 30 patients with non-local anesthetic drug intoxication were enrolled and randomly assigned to case (n=15) and control (n=15) groups. In the case group, all patients received 10cc/kg intralipid 10% infusion. The patients in the control group just received supportive care. The patients' demographic and clinical characteristics and the results of their laboratory tests were evaluated upon admission and 6 hours after that.
Results: Mean age was 23±5 and 28±11 years in cases and controls, respectively. There were no significant statistical differences between these two groups in terms of age, gender, elapsed time between intubation and extubation, and prevalence of need for intubation and/or mechanical ventilation (P=0.70 and P= 1.00, respectively). Also, systolic blood pressure, pulse rate, mean rate- pressure product, respiratory rate, and results of acid-base gas, serum sodium, potassium, urea, and creatinine tests upon admission and six hours later were not significantly different between the two groups. However, a significant difference was found between the two groups in terms of GCS difference (P= 0.048) and blood glucose six hours after presentation (P= 0.04).
Conclusions: In the setting of non-local anesthetic drug overdose, intravenous intralipid infusion can increase GCS and interestingly, decrease the blood glucose.
