Serum Cholinesterase Levels In Organophosphorus Poisoning Patients On Ventilatory Support

Abstract

Background Organo-phosphorus poisoning is a major public health problem in developing world. OP poisoning is associated with decrease in serum cholinesterase level. This study is aimed to estimate serum cholinesterase enzyme levels serially and to evaluate the prognostic value of serum cholinesterase in OP poisoning patients. Materials and Methods This is a prospective study done at Shri B.M. Patil Medical College, Hospital and Research Centre, Vijayapur with a sample size of 70. Serial estimation of serum cholinesterase was done at the time of admission, 3rd, 5th, 7th,9th, and 11th day in patients who fulfilled the inclusion criteria. Results There were 42 males and 28 females. Majority of them (73%) were below 40years of age, and from rural areas. There was suppression of SCE in all of the patients on the day of presentation. 55 out of 70 patients had values of < 1962 IU/L. Majority (>78%), had moderate to severe poisoning based on serum cholinesterase values, as per Proudfoot classification. Only 21% had mild poisoning. Conclusion Study revealed decrease levels of pseudocholinesterase levels at the time of admission in organophosphorus poisoning patients with subsequent return to normal values during hospital stay. Their was direct correlation between the severe suppression of SCE levels and the clinical severity of poisoning such as presence of ventilator insufficiency and mortality. There was good correlation between improvement in patient’s motor power and improved serum cholinesterase levels during the time the patients were successfully weaned.