The Spectrum of Intermediate Syndrome Following Acute Organophosphate Poisoning: A Prospective Cohort Study from Sri Lanka

@article{Jayawardane2008TheSO,
  title={The Spectrum of Intermediate Syndrome Following Acute Organophosphate Poisoning: A Prospective Cohort Study from Sri Lanka},
  author={Pradeepa Jayawardane and Andrew H Dawson and Vajira S Weerasinghe and Lakshman Delgoda Karalliedde and Nicholas A Buckley and Nimal Senanayake},
  journal={PLoS Medicine},
  year={2008},
  volume={5}
}
Background Intermediate syndrome (IMS) is a major cause of death from respiratory failure following acute organophosphate poisoning. The objective of this study was to determine repetitive nerve stimulation (RNS) predictors of IMS that would assist in patient management and clinical research. Methods and Findings Seventy-eight consenting symptomatic patients with organophosphate poisoning were assessed prospectively with daily physical examination and RNS. RNS was done on the right and left… Expand
Clinical profile of Intermediate Syndrome following Organophosphate Poisoning
TLDR
Prevalence of Intermediate Syndrome (IMS) in this study was lower than previous reports with almost similar clinical features, and is a rare and life-threatening problem in OP intoxication. Expand
THE SPECTRUM OF INTERMEDIATE SYNDROME FOLLOWING ACUTE ORGANOPHOSPHORUS POISONING: A RETROSPECTIVE COHORT STUDY FROM A TEACHING HOSPITAL OF CHHATTISGARH
TLDR
Patients with respiratory muscle weakness & proximal muscle paresis were the definitive predictors for the development of intermediate syndrome. Expand
Electrophysiological correlates of intermediate syndrome following acute organophosphate poisoning
TLDR
Early occurrence of abnormalities on repetitive nerve stimulation studies suggest that this is part of the continuum of nicotinic receptor stimulation, a spectrum disorder affecting the neuromuscular junction with two main forms: a forme fruste variety associated with mild weakness and the classical IMS with weakness. Expand
Electrophysiological correlates of respiratory failure in acute organophosphate poisoning: Evidence for differential roles of muscarinic and nicotinic stimulation
TLDR
The normal RNS in all patients developing early respiratory failure suggests that it is due to a central nervous system (CNS) and muscarinic effect, which emphasizes the need for early rapid atropinisation as a priority, combating the nicotinic effects being less urgent. Expand
Incidence, predictors, and outcome of intermediate syndrome in cholinergic insecticide poisoning: A prospective observational cohort study
TLDR
As with exposure to organophosphorus, carbamate also result in intermediate syndrome; risk may be high with age ≥ 45, admission score of PSS > 2, and GCS ≤ 10, and multiple gastric lavages may be protective. Expand
A comprehensive review on experimental and clinical findings in intermediate syndrome caused by organophosphate poisoning.
TLDR
The aim of this study was to revisit current knowledge related to OP and the IMS, and found that toxicokinetic factors, such as a high lipid-solubility, duration of AChE inhibition and metabolite excretion, evolution of alterations on repetitive nerve stimulation (RNS), type and frequency of muscle lesions can estimate the probability of theIMS. Expand
Commentary: An electrophysiological study of the intermediate syndrome of organophosphate poisoning
TLDR
The late onset respi- ratory failure of IMS contributes to much of the morbidity and mortality related to organophosphate poisoning. Expand
Differences between organophosphates in respiratory failure and lethality with poisoning post the 2011 bans in Sri Lanka
TLDR
RF and deaths following OP ingestion continue to be a major problem in Sri Lanka, with profenofos being the major current agent of concern and strategies to replace profen ofos and quinalphos use with less toxic insecticides should be explored. Expand
Serum creatine phosphokinase as predictor of intermediate syndrome in organophosphorus poisoning
TLDR
Increased serum CPK levels at 48 h after poisoning was observed in all the patients, but three patients had more than 1500 IU/L, who manifested with IMS, and early diagnosis of IMS by serial estimation of CPK may help in timely intervention and reduce further life-threatening complications. Expand
A clinico-epidemiological profile of organophosphorous compound poisoning, a retrospective study in a tertiary hospital, in Puducherry
TLDR
There is a further need for prospective studies to study in detail the clinico-epidemiological profile and treatment modalities to predict the outcome of OPC poisoning. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 50 REFERENCES
Intermediate myasthenia syndrome following acute organophosphates poisoning-an analysis of 21 cases
TLDR
Intermediate Myasthenia Syndrome occurred mainly in severe OP poisoning patients who recovered from the acute cholinergic crisis at 7-75 h after the onset of acute poisoning. Expand
Respiratory failure in acute organophosphorus pesticide self-poisoning.
TLDR
Respiratory failure did not occur as two discrete clinical syndromes within distinct time frames, instead, the pattern of failure was variable and overlapped in some patients, and there seemed to be two underlying mechanisms (an early acute mixed central and peripheral respiratory failure, and a late peripheral respiratory Failure). Expand
Intermediate syndrome in organophosphorus poisoning: A prospective study
TLDR
The intermediate syndrome is not rare, although it is more likely to occur with some organophosphates, it is not confined to a few distinct compounds, and is not due to muscle fiber necrosis. Expand
Organophosphate poisoning: Diagnosis of intermediate syndrome
TLDR
Electro physiological monitoring using repetitive nerve stimulation is a poorly sensitive marker in diagnosing intermediate syndrome after OPC poisoning and needs to develop more sensitive markers to diagnose IMS. Expand
Oxidative damage in intermediate syndrome of acute organophosphorous poisoning.
TLDR
In acute organophosphate poisoning, severe and prolonged acetylcholinesterase inhibition is associated with oxidative stress, detected in erythrocyte membranes, that occurs early in the course of poisoning and may contribute to the development and severity of intermediate syndrome. Expand
Serial neuro-electrophysiological studies in acute organophosphate poisoning--correlation with clinical findings, serum cholinesterase levels and atropine dosages.
TLDR
At admission, level of serum cholinesterase of less than 200 units is a predictor and the 30 Hz RNS decremental response could be a useful marker for the 'Intermediate Syndrome'. Expand
The intermediate syndrome in organophosphate poisoning: presentation of a case and review of the literature.
A dimethoate-poisoned woman gradually developed a moderately severe cholinergic crisis that was readily treated by atropine. After being symptom-free for nearly two days, she suffered from suddenExpand
Muscle injury in organophosphorous poisoning and its role in the development of intermediate syndrome.
TLDR
The findings of this study suggest that Types I and II paralysis in organophosphate poisoning are not separate syndromes but a clinical continuum determined by the severity of poisoning. Expand
Differences between organophosphorus insecticides in human self-poisoning: a prospective cohort study
TLDR
Organophosphorus insecticide poisoning is not a single entity, with substantial variability in clinical course, response to oximes, and outcome and, consequently, patients might benefit from management protocols developed for particular organoph phosphorus insecticides. Expand
Acute and subacute organophosphate poisoning in the rat.
TLDR
The data argues against the monophasic necrotizing myopathy being the cause of the intermediate syndrome, and is suggestive of persistent AChE inhibition being involved. Expand
...
1
2
3
4
5
...