Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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Assessment and Methods of Nutritional Support during Atropinization in Organophosphate and Carbamate Poisoning Cases

아트로핀으로 치료하는 유기인계와 카바메이트 중독 환자의 영양지원 평가와 방법

  • Park, Jong-uk (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Min, Young-gi (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Choi, Sangcheon (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Ko, Dong-wan (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Park, Eun Jung (Department of Emergency Medicine, Ajou University School of Medicine)
  • 박종욱 (아주대학교 의과대학 응급의학교실) ;
  • 민영기 (아주대학교 의과대학 응급의학교실) ;
  • 최상천 (아주대학교 의과대학 응급의학교실) ;
  • 고동완 (아주대학교 의과대학 응급의학교실) ;
  • 박은정 (아주대학교 의과대학 응급의학교실)
  • Received : 2020.07.06
  • Accepted : 2020.09.15
  • Published : 2020.12.31
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Abstract

Purpose: Atropine is an antidote used to relieve muscarinic symptoms in patients with organophosphate and carbamate poisoning. Nutritional support via the enteral nutrition (EN) route might be associated with improved clinical outcomes in critically ill patients. This study examined the administration of nutritional support in patients undergoing atropinization, including methods of supply, outcomes, and complications. Methods: A retrospective observational study was conducted in a tertiary care teaching hospital from 2010 to 2018. Forty-five patients, who were administered with atropine and on mechanical ventilation (MV) due to organophosphate or carbamate poisoning, were enrolled. Results: Nutritional support was initiated on the third day of hospitalization. Thirty-three patients (73.3%) were initially supported using parenteral nutrition (PN). During atropinization, 32 patients (71.1%) received nutritional support via EN (9) or PN (23). There was no obvious reason for not starting EN during atropinization (61.1%). Pneumonia was observed in both patient groups on EN and PN (p=0.049). Patients without nutritional support had a shorter MV duration (p=0.034) than patients with nutritional support. The methods of nutritional support during atropinization did not show differences in the number of hospital days (p=0.711), MV duration (p=0.933), duration of ICU stay (p=0.850), or recovery at discharge (p=0.197). Conclusion: Most patients undergoing atropinization were administered PN without obvious reasons to preclude EN. Nutritional support was not correlated with the treatment outcomes or pneumonia. From these results, it might be possible to choose EN in patients undergoing atropinization, but further studies will be necessary.

Keywords

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