Whether Patients With Severe Organophosphate Poisoning Early Indicators Analysis Of Mechanical Ventilation Therapy

Organ phosphorus pesticide is commonly used insecticides in rural areas inChina, can through the digestive tract, respiratory tract, and skin absorption intothe bloodstream, and in areas such as the symptoms of heavy, mortality is higher.Organ phosphorus pesticide poisoning the main complications of respiratoryfailure, respiratory failure for its one of the most common cause of death. It is themost common cause of respiratory failure in acute pulmonary edema, followed byparalysis of the breathing machine; both can exist at the same time. When acuterespiratory failure, early detection, and in a timely manner to give emergencytracheal intubation, auxiliary ventilation breathing machine, is the key to rescueacute severe organophosphate poisoning, can improve the success rate of rescueand improve prognosis. Clinical diagnosis index of convenient and feasible,therefore, to determine whether patients with organ phosphorus poisoning requiremechanical ventilation therapy is critical.Objective: through observing acute organophosphate poisoning patientsadmitted to hospital information prospective study and discussion and analysis ofearly acute organophosphate poisoning patients, practical, simple and effectivejudgment whether respiratory failure, need mechanical ventilation relatedindicators.Methods: collected in January2011-December2013in our hospitalemergency department and ICU, a total of200patients with acute organphosphorus poisoning in the hospital, after exclusion of a total of156patientseligible for observation. Age, gender, amount of poison, poison to gastric lavage,to commit to admission time and so on general situation, parallel routine blood,liver, kidney function, myocardial enzyme, cholinesterase and routine laboratory tests such as blood gas analysis. According to whether patients with respiratoryfailure, mechanical ventilation therapy, patients can be divided into themechanical ventilation and mechanical ventilation group. Determine the bloodroutine, two groups of patients with renal function, myocardial enzyme, liverfunction, blood gas analysis and hospital1h,6h,24h,3d,7d serumcholinesterase activity and statistical analysis, etc.Results:(1) the mechanical ventilation group commit quantity20.2+/-13.6ml, mechanical ventilation group commit quantity64.8+/-36.9ml, two groupsof patients in terms of amount of poison significant difference (P <0.01). Routinelaboratory aspects reflect the blood of the state of the body’s inflammatory whiteblood cells (WBC) in the two groups are statistically significant (P <0.05).(2)reflect the renal function indexes of blood BUN and blood Cr differences (P <0.05); Reflect impaired liver blood ALT significant differences in the two groups(P <0.01); CK-MB reflect myocardial damage significant differences comparingthe two groups (P <0.01). According to the damage of kidney, liver, myocardium,and then judge the prognosis of the patients.(3) mechanical ventilation patientsbecause of respiratory failure, arterial blood gas analysis checks visible, PO2andPCO2change obviously, requires correct mechanical ventilation, significantdifferences between two groups (P <0.01); In terms of PH, BE, and thedetermination of lac, differences between two groups (P <0.05).(4) in patientswith acute organ phosphorus poisoning, according to whether the occurrence ofrespiratory failure, it can be divided into two groups, after the same treatment, twogroups of patients complicated with other viscera damage significant differencesin the incidence of significant differences (P <0.01), the death rate (P <0.01). Theincidence of complications and mortality mechanical ventilation group wasobviously higher than that of the mechanical ventilation group.(5) Acuteorganophosphate poisoning patients admitted to hospital after all can give plentyof cholinesterase complex agent, the comparison between the two groups, in thehospital after1hour,24hours of determination of serum cholinesterase activity, there are significant differences (P <0.05); Three days after the serumcholinesterase activity is obvious difference between two groups (P <0.05)（6）Serum cholinesterase of ROC curve shows the area under the curve (AUC0.780,(95%[CI],0.7110.961), the optimal cut-off point for172tendency for L,sensitivity was78.7%, specificity of31.3%.Conclusion:(1) dose of organ phosphorus pesticide, blood leucocyte index,index of liver function, renal function index, the damage of myocardial enzymeindex can be used as assessment of whether the line of mechanical ventilation inpatients with severe organophosphate poisoning treatment early laboratory indexes.Mechanical ventilation group, the amount of medication, an elevated significantly,liver, kidney, myocardium injury.(2) Mechanical ventilation group of patientswith severe poisoning can exist at the same time multiple organ damage, theincidence of complications and mortality increased significantly.(3) The PH, PO2,PCO2measurement, blood gas analysis can be used as an assessment of whetherthe line of mechanical ventilation in patients with severe organophosphatepoisoning treatment early laboratory indexes.(4) Serum cholinesterase, highsensitivity, specificity, can be used as an assessment of whether the line ofmechanical ventilation in patients with severe organophosphate poisoningtreatment early laboratory indexes.