Singh Omender, Javeri Yash, Juneja Deven, Gupta Manish, Singh Gurpreet, Dang Rohit
Department of Critical Care Medicine, Max Super Speciality Hospital, Saket, Delhi, India.
Indian J Anaesth. 2011 Jul;55(4):370-4. doi: 10.4103/0019-5049.84860.
There is scarcity of data from the Indian subcontinent regarding the profile and outcome of patients presenting with acute poisoning admitted to intensive care units (ICU). We undertook this retrospective analysis to assess the course and outcome of such patients admitted in an ICU of a tertiary care private hospital.
We analyzed data from 138 patients admitted to ICU with acute poisoning between July 2006 and March 2009. Data regarding type of poisoning, time of presentation, reason for ICU admission, ICU course and outcome were obtained.
Seventy (50.7%) patients were males and majority (47.8%) of admissions were from age group 21 to 30 years. The most common agents were benzodiazepines, 41/138 (29.7%), followed by alcohol, 34/138 (24.63%) and opioids, 10/138 (7.2%). Thirty-two (23%) consumed two or more agents. Commonest mode of toxicity was suicidal (78.3%) and the route of exposure was mainly oral (97.8%). The highest incidence of toxicity was due to drugs (46.3%) followed by household agents (13%). Organ failure was present in 67 patients (48.5%). During their ICU course, dialysis was required in four, inotropic support in 14 and ventilator support in 13 patients. ICU mortality was 3/138 (2.8%). All deaths were due to aluminium phosphide poisoning.
The present data give an insight into epidemiology of poisoning and represents a trend in urban India. The spectrum differs as we cater to urban middle and upper class. There is an increasing variety and complexity of toxins, with substance abuse attributing to significant number of cases.
关于入住重症监护病房(ICU)的急性中毒患者的资料,印度次大陆的数据较为匮乏。我们进行了这项回顾性分析,以评估在一家三级护理私立医院的ICU中收治的此类患者的病程及转归。
我们分析了2006年7月至2009年3月期间入住ICU的138例急性中毒患者的数据。获取了关于中毒类型、就诊时间、入住ICU的原因、ICU病程及转归的数据。
70例(50.7%)患者为男性,大多数(47.8%)的入院患者年龄在21至30岁之间。最常见的毒物是苯二氮䓬类药物,138例中有41例(29.7%),其次是酒精,138例中有34例(24.63%),阿片类药物138例中有10例(7.2%)。32例(23%)患者摄入了两种或更多种毒物。最常见的中毒方式是自杀(78.3%),接触途径主要是口服(97.8%)。中毒发生率最高的是药物(46.3%),其次是家用制剂(13%)。67例(48.5%)患者出现器官衰竭。在其ICU病程中,4例患者需要透析,14例需要使用血管活性药物支持,13例需要呼吸机支持。ICU死亡率为138例中的3例(2.8%)。所有死亡均因磷化铝中毒。
目前的数据有助于深入了解中毒的流行病学情况,并代表了印度城市的一种趋势。由于我们针对的是城市中上层阶级,情况有所不同。毒素的种类和复杂性日益增加,药物滥用导致了大量病例。