Akademik Veri Yönetim Sistemi
Acta Medica Mediterranea, cilt.30, sa.6, ss.1279-1283, 2014 (SCI-Expanded)
Introduction and objective: Organophosphates are frequently used for agricultural spraying in an uncontrolled manner in our country. Humans are usually inadvertently exposed to these chemicals via respiratory, transdermal, or transconjunctival routes whereas they may also be used for suicidal purposes. Having a high morbidity and mortality, this intoxication causes a high emergency department admission rate (1). Previous studies on lipid therapy in cardiac arrest associated with intoxication of lipophilic agents such as antidepressants, anticonvulsants, antihypertensives, and local anesthetics have reported a 55% increase in survival with these therapies (2). We also studied lipid emulsion therapy (LET) in poisoning with organophosphates that are lipophilic. Materials and method: This study used 30 male Wistar-albino rats of 12 months of age weighting 288 to 428 gr. The animals were randomly grouped into 5 groups. Group 1 was the control group; Group 2 organophosphate+serum physiologic (SF) group; Group 3 organophosphate+LET group; Group 4 organophosphate + Atropin(A)+ Pralidoxime (PAM) group, and Group 5 organophosphate+ LET+A+PAM group. After an 8-hour clinical observation period the rats were sacrificed and blood pseudocholinesterase, cholesterol, and triglyceride levels were studied. Renal, hepatic, splenic, and cerebral tissues were sampled to be examined under light microscope. Results: There were significant differences between the groups with respect to cholesterol, triglyceride, but not pseudocholinesterase level. Dizziness was the first observed clinical symptom, followed by hindleg paralysis, foreleg paralysis, and general paralysis. After general paralysis salivation was usually observed together with gasping breathing. Rats with the above clinical course were sacrificed. The clinical picture progressed rapidly after foreleg paralysis. The toxic clinical course was observed in 100% of rats in Group 2 (organophosphate + SF) and Group 3 (Organophosphate +LET) and its mortality rate was high. No significant difference was observed between both groups with respect to time to symptom onset. This may be interpreted as that LET treatment alone was not effective. Conclusion: In the present study we did not observe any beneficial effect of LE treatment alone on mortality of organophosphate intoxication. According to our results, however, it may be beneficial when used in conjunction to classical therapy. Considering its relatively low side effect profile and pros and cons, we believe that it can be used as a supportive therapy in organophosphate poisoning.