Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation

KÖYLÜ, Ramazan; AKILLI, Nazire Belgin; GÜNAYDIN, Yahya Kemal; DÜNDAR, ZERRİN DEFNE; MUTLU, Hüseyin; Cander, Başar; GÖNEN, Önder

Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation

Yahya Kemal GÜNAYDIN, (Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye)

Zerrin Defne DÜNDAR, (Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye)

Ramazan KÖYLÜ, (Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye)

Önder GÖNEN, (Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye)

Hüseyin MUTLU, (Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye)

Nazire Belgin AKILLI, (Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye)

Başar CANDER (Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye)

Eurasian Journal of Emergency Medicine

1 0

Yıl: 2015 Cilt: 14 Sayı: 1 Sayfa Aralığı: 2 - 7 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation

Öz:

Amaç: Zehirlenme vakaları sıklıkla müdahale etme amaçlı değil yakın gözlem ve monitörizasyon amaçlı yoğun bakım ünitelerine yatırılır. Bazen endotrakeal entübasyona ve mekanik ventilasyon desteğine ihtiyaç duyulabilir. Gereç ve Yöntemler: Toksikoloji yoğun bakım ünitemize ardışık olarak 2011 Mart - 2013 Mart ayları arasında toplam 2118 intoksikasyon olgusu yatırılmıştır. Bu hastalardan endotrakeal entübasyon ve mekanik ventilasyon ihtiyacı olan toplam 23 olgu çalışmaya dahil edilmiştir. Çalışmamız retroprospektif bir çalışma olup, bilgiler hasta dosyaları taranarak elde edilmiştir. Bulgular: 23 olgunun (%1.1) mekanik ventilatör ihtiyacı olmuş ve yalnızca 7 (%0.33) olgu hayatını kaybetmiştir. Mekanik ventilasyon ihtiyacının en sık sebebi bilinç bozukluğu ve solunum yetmezliği idi. Olgular ortalama 7.95 gün toksikoloji yoğun bakım ünitesinde takip edilmiştir. Yattıkları süre içerisinde ortalama 4.17 gün mekanik ventilatöre bağlı kalmıştır. Organofosfat zehirlenmesi olgularının ortalama mekanik ventilatör süreleri 6.92 gün iken diğer organofosfat olmayan grubunki ise 1.18 gündür. İki grup arasında istatistiki olarak anlamlı farklılık vardır. (p<0.01) Organofosfat zehirlenmesi olguları ile diğer organofosfat olmayan grubu başvuru sırasındaki GKS, arter kan gazı, crp, prokalsitonin ve troponin değerleri açısından karşılaştırdık. Prokalsitonin değerleri organofosfat grubunda istatistiki olarak anlamlı şekilde yüksekti.(p=0.003) Sonuç: Mekanik ventilasyon ihtiyacı gösteren zehirlenme olguları klasik zehirlenme epidemiyolojisinden yaş ve cinsiyet olarak farklılık gösterebilir. Organofosfat zehirlenmeleri en çok mekanik ventilasyon ihtiyacı gösteren ve mortalitesi en yüksek zehirlenme türlerinden biridir.

Anahtar Kelime:

Konular: Acil Tıp

Mekanik Ventilasyon İhtiyacı Olan Zehirlenme Olgularının Retrospektif Olarak İncelenmesi

Öz:

Aim: Intoxication cases are hospitalized in intensive care units not for intervention but for close observation and monitoring. Endotracheal intubation and mechanical ventilation may sometimes be required. Materials and Methods: In total, 2118 intoxication cases have been hospitalized in our toxicology intensive care unit sequentially between March 2011 and March 2013. Of these patients, 23 cases that required endotracheal intubation and mechanical ventilation were included in this retrospective study; data was obtained by screening the patient files. Results: Twenty-three cases (1.1%) required mechanical ventilation, and only 7 cases (0.33%) died. The most common reasons for requiring mechanical ventilation were unconsciousness and respiratory failure. During hospitalization, they were attached to mechanical ventilator for a mean of 4.17 days. While the mean duration of mechanical ventilation of patients with organophosphate intoxication was 6.92 days, the other non-organophosphate intoxication group was 1.18 days. There is significant statistical difference between two groups (p<0.01). We compared the organophosphate intoxication group with other non-organophosphate intoxication group for Glasgow Coma Scale, arterial blood gas, C-reactive protein, and pro-calcitonin and troponin levels at initial admission. Pro-calcitonin levels were significantly high in the organophosphate group.Conclusion: Intoxication cases that require mechanical ventilation can differ from classical intoxication epidemiology for age and sex. Organophosphate intoxications are one of the intoxication types that require mechanical ventilation and have the highest mortality

Anahtar Kelime:

Konular: Acil Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Chirasirisap K, Ussanawarong S, Tassaneeyakul W, Reungsritrakool W, Prasitwatanaseree W, Sripanyawit U, et al. A study of major causes and types of poisoning in Khonkaen, Thailand. Vet Hum Toxicol 1992; 34: 489- 92.
Beers MH, Berkow R. Eds. The Merck Manual of Diagnosis and Therapy 17.Edition. Merck Research Laboratories, New Jersey 1999. p. 2619.
Fuller GN, Rea AJ, Payne JF, Lant AF. Parasuicide in central London 1984- 1988. J R Soc Med 1989; 82: 653-6.
Kurtoğlu S. Diagnosis and Treatment of Poisoning. 1 issue. Kayseri: Erci- yes University Press;1992; 1-47.
Leykin Y, Halpern P, Silbiger A, Sorkin P, Niv D, Rudick V, et al. Acute poi- soning treated in the intensive care unit: a case series. Isr J Med Sci 1989; 25: 98-102.
Rosen P, Barkin R. Emergency Medicine Conceps and Clinical Practice. 7th ed. USA: Mosby, 2010: 1947-85.
Wax PM. Historical principles and perspectives. In: Goldfrank LR, Flo- menbaum NE, Lewin NA, Weisman RS, Howland MA, Hoffman RS, eds. Goldfrank's Toxicologic Emergencies, 7th edition, USA, The McGraw-Hill Companies, 2002: 1-17.
Gunnell D, Eddleston M. Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. Int J Epidemiol 2003; 32: 902-9. [CrossRef]
Viertel A, Weidmann E, Brodt HR. Cases of acute poisoning admitted to a medi- cal ıntensive care unit. Dtsch Med Wochenschr 2001; 126: 1159-63. [CrossRef]
Juarez-Aragon G, Castanon-Gonzalez JA, Perez-Morales AJ, Mon- toya-Cabrera MA. Clinical and epidemiological characteristics of severe poisoning in an adult population admitted to an ıntensive care unit. Gac Med Mex 1999; 135: 669-75.
Joubert PH. Poisoning admissions of black South Africans. J Toxicol Clin Toxicol 1990; 28: 85-94. [CrossRef]
Cengiz M, Baysal Z, Ganidagli S, Altindag A. Characteristics of poisoning cases in adult intensive care unit in Sanliurfa, Turkey. Saudi Med J 2006; 27: 497-502.
Henderson A, Wright M, Pond SM. Experience with 732 acute overdose patients admitted to an intensive care unit over six years. Med J Aust 1993; 158: 28-30.
Eddleston M, Haggalla S, Reginald K, Sudarshan K, Senthilkumaran M, Karalliedde L, et al. The hazards of gastric lavage for intentional self-poi- soning in a resource poor location. Clin Toxicol (Phila) 2007; 45: 136-43. [CrossRef]
Litovitz TL, Klein-Schwartz W, White S, Cobaugh DJ, Youniss J, Omslaer JC, et al. 2000 annual report of the American Association of Poison Control Cen- ters toxic exposure surveillance system. Am J Emerg Med 2001; 19: 337-95. [CrossRef]
Banerjee S, Chowdhury AN, Schelling E, Brahma A, Biswas MK, Weiss MG. Deliberate self-harm and suicide by pesticide ingestion in the Sundar- ban region, India. Trop Med Int Health 2009; 14: 213-9. [CrossRef]
Şencan A, Adanır T, Aksun M, Karahan N, Aran G. Accepted Intensive Care Unit Patients with Acute poisoning etiologic features individual and rela- tionship with mortality. Türk Anest Rean Association Journal 2009; 37: 80-5.
Lam SM, Wing Lau AC, Wa Yan W. Over 8 years experience on severe acute poisoning requiring intensive care in Hong Kong, China. Hum Exp Toxicol 2010; 29: 757-65. [CrossRef]
Singh O, Javeri Y, Juneja D, Gupta M, Singh G, Dang R. Profile and out- come of patients with acute toxicity admitted in intensive care unit: Experiences from a major corporate hospital in urban India. Indian J An- aesth 2011; 55: 370-4. [CrossRef]
Jeyaratnam J. Acute pesticide poisoning: a major global health problem. World Health Stat Q 1990; 43: 139-44.
Bilgin TE, Camdeviren H, Yapici D, Doruk N, Altunkan AA, Altunkan Z, et al. The comparison of the efficacy of scoring systems in organophos- phate poisoning. Toxicol Ind Health 2005; 21: 141-6. [CrossRef]
Dong X, Simon MA. The epidemiology of organophosphate poisoning in ur- ban Zimbabwe from 1995 to 2000. Int J Occup Environ Health 2001; 7: 333-8. [CrossRef]
Schwake L, Wollenschlager I, Stremmel W, Encke J. Adverse drug reac- tions and deliberate self-poisoning as cause of admission to the inten- sive care unit: a 1-year prospective observational cohort study. Intensive Care Med 2009; 35: 266-74. [CrossRef]
Emerson GM, Gray NM, Jelinek GA, Mountain D, Mead HJ. Organophos- phate poisoning in Perth Western Australia, 1987-1996. J Emerg Med 1999; 17: 273-7. [CrossRef]
Goksu S, Yildirim C, Kocoglu H, Tutak A, Oner U. Characteristics of acute adult poisoning in Gaziantep, Turkey. J Toxicol Clin Toxicol 2002; 40: 833-7. [CrossRef]
Demir G, Eren GA, Hergünsel O, Çukurova Z, Kızanlık Y. Tagged with in- tensive care unit, 2003-2007 retrospective analysis of cases of poisoning. Medical Journal of Bakırköy 2008; 4: 139-43.

APA	GÜNAYDIN Y, DÜNDAR Z, KÖYLÜ R, GÖNEN Ö, MUTLU H, AKILLI N, Cander B (2015). Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. , 2 - 7.
Chicago	GÜNAYDIN Yahya Kemal,DÜNDAR ZERRİN DEFNE,KÖYLÜ Ramazan,GÖNEN Önder,MUTLU Hüseyin,AKILLI Nazire Belgin,Cander Başar Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. (2015): 2 - 7.
MLA	GÜNAYDIN Yahya Kemal,DÜNDAR ZERRİN DEFNE,KÖYLÜ Ramazan,GÖNEN Önder,MUTLU Hüseyin,AKILLI Nazire Belgin,Cander Başar Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. , 2015, ss.2 - 7.
AMA	GÜNAYDIN Y,DÜNDAR Z,KÖYLÜ R,GÖNEN Ö,MUTLU H,AKILLI N,Cander B Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. . 2015; 2 - 7.
Vancouver	GÜNAYDIN Y,DÜNDAR Z,KÖYLÜ R,GÖNEN Ö,MUTLU H,AKILLI N,Cander B Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. . 2015; 2 - 7.
IEEE	GÜNAYDIN Y,DÜNDAR Z,KÖYLÜ R,GÖNEN Ö,MUTLU H,AKILLI N,Cander B "Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation." , ss.2 - 7, 2015.
ISNAD	GÜNAYDIN, Yahya Kemal vd. "Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation". (2015), 2-7.

APA	GÜNAYDIN Y, DÜNDAR Z, KÖYLÜ R, GÖNEN Ö, MUTLU H, AKILLI N, Cander B (2015). Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. Eurasian Journal of Emergency Medicine, 14(1), 2 - 7.
Chicago	GÜNAYDIN Yahya Kemal,DÜNDAR ZERRİN DEFNE,KÖYLÜ Ramazan,GÖNEN Önder,MUTLU Hüseyin,AKILLI Nazire Belgin,Cander Başar Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. Eurasian Journal of Emergency Medicine 14, no.1 (2015): 2 - 7.
MLA	GÜNAYDIN Yahya Kemal,DÜNDAR ZERRİN DEFNE,KÖYLÜ Ramazan,GÖNEN Önder,MUTLU Hüseyin,AKILLI Nazire Belgin,Cander Başar Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. Eurasian Journal of Emergency Medicine, vol.14, no.1, 2015, ss.2 - 7.
AMA	GÜNAYDIN Y,DÜNDAR Z,KÖYLÜ R,GÖNEN Ö,MUTLU H,AKILLI N,Cander B Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. Eurasian Journal of Emergency Medicine. 2015; 14(1): 2 - 7.
Vancouver	GÜNAYDIN Y,DÜNDAR Z,KÖYLÜ R,GÖNEN Ö,MUTLU H,AKILLI N,Cander B Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation. Eurasian Journal of Emergency Medicine. 2015; 14(1): 2 - 7.
IEEE	GÜNAYDIN Y,DÜNDAR Z,KÖYLÜ R,GÖNEN Ö,MUTLU H,AKILLI N,Cander B "Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation." Eurasian Journal of Emergency Medicine, 14, ss.2 - 7, 2015.
ISNAD	GÜNAYDIN, Yahya Kemal vd. "Retrospective Investigation of Intoxication Cases That Require Mechanical Ventilation". Eurasian Journal of Emergency Medicine 14/1 (2015), 2-7.