Author/Editor		Sinkovič, A
Title		Zastrupitev z organofosfornim insekticidom
Translated title		Acute intoxication with organophosphorous insecticides
Type		članek
Source		In: Borin P, Hojs R, Kamenik B, et al, editors. "Iz prakse za prakso". 4. mariborsko srečanje internistov in zdravnikov splošne medicine: nekatera izbrana poglavja iz urgentne interne medicine; 1993 okt 16; Maribor. Maribor: Zdravniško društvo Maribor,
Publication year		1993
Volume		str. 105-10
Language		slo
Abstract		Intoxications with organophosphorous insecticides are relatively frequent in our part of the country (9 cases in 1992). They must be taken seriously since they are potentially life-threatening. Quick recognition and immediate treatment are therefore essential. The case of a 32-year-old female patient treated for suicidal intoxication with folidol is presented. At admission she was comatose, dyspneic with profuse bronchorrhea, perspiration, decreased serum cholinesterase (12.3). Early large-dose atropinization (with regard to bronchorrhea) and administration of antidotes improved the clinical picture within a few hours. Using extensive gastric lavage, the application of animal charcoal and laxative, as much of the poison as possible was removed from the gastrointestinal tract. Three days later there was a deterioration of the clinical picture with reapperance of bronchorrhea, perspiring, dyspnea, development of acute respiratory insufficiency with a drop in pA02 (pH 7.403, pA02 4.95, pACO2 4.404) and a new decrease in serum cholinesterase (from 24.2 to 13.7), owing to which even mechanical ventilation (CMV, Fi02 40%) with benzodiazepine sedation was necessary. The cause for the deterioration was the repeated resorption of the incompletely removed poison from the bowels. Repeated and final improvement of the clinical picture after mechanical ventilation, atropinization and complete removal of the poison by laxatives coincided with normal values of serum cholinesterase. The patient was discharged after 12 days with no sequelae.
Descriptors		INSECTICIDES, ORGANOPHOSPHATE ADULT ACUTE DISEASE