Karthik Gunasekaran, Iyadurai Ramya, Ralph Ravikar, Prakash Vijay, Abhilash K P Prabhakar, Sathyendra Sowmya, Abraham O C, Truman Catherine, Reginald Alex
Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
J Family Med Prim Care. 2020 Jan 28;9(1):136-140. doi: 10.4103/jfmpc.jfmpc_632_19. eCollection 2020 Jan.
Yellow oleander (), which belongs to the Apocyanaceae family, is a common shrub seen throughout the tropics. All parts of the plant contain high concentrations of cardiac glycosides which are toxic to cardiac muscle and the autonomic nervous system. Here, we describe the clinical profile of patients with oleander poisoning and their outcomes.
This retrospective study was conducted over a period of 12 months (March 2016 to February 2017). The data was extracted from the inpatient electronic medical records. Adult patients with a diagnosis of acute yellow oleander poisoning were included in the study. Descriptive statistics were obtained for all variables in the study and appropriate statistical tests were employed to ascertain their significance.
The study comprised 30 patients aged 30.77 ± 12.31 (mean ± SD) who presented at 12.29 ± 8.48 hours after consumption of yellow oleander. Vomiting (80%) was the most common presenting symptom. Metabolic abnormalities at presentation included hyperchloremia in 22 patients and metabolic acidosis (bicarbonate <24 mmol/L) in 29 patients. Fifteen (50%) patients had abnormal ECG, of which second-degree AV block was the commonest ECG abnormality seen in 4 (13.3%). Fifteen (50%) patients had transvenous temporary pacemaker insertion (TPI). Having a TPI significantly prolonged the duration of hospital stay (OR 1.85, 95% CI 1.06-3.21, 0.03). The mortality in the cohort was 2 (6.7%).
In patients with yellow oleander poisoning, dyselectrolytemia with ECG abnormalities was common. TPI prolonged the duration of hospital stay. Further studies are required to know the indication for and to ascertain the effect of temporary pacing on survival.
黄花夹竹桃属于夹竹桃科，是一种在热带地区常见的灌木。该植物的所有部位都含有高浓度的强心苷，对心肌和自主神经系统有毒性。在此，我们描述了黄花夹竹桃中毒患者的临床特征及其预后情况。
本回顾性研究为期12个月（2016年3月至2017年2月）。数据从住院电子病历中提取。纳入研究的为诊断为急性黄花夹竹桃中毒的成年患者。对研究中的所有变量进行描述性统计，并采用适当的统计检验来确定其显著性。
该研究包括30例年龄为30.77±12.31（均值±标准差）的患者，他们在食用黄花夹竹桃后12.29±8.48小时就诊。呕吐（80%）是最常见的就诊症状。就诊时的代谢异常包括22例高氯血症和29例代谢性酸中毒（碳酸氢根<24 mmol/L）。15例（50%）患者心电图异常，其中二度房室传导阻滞是最常见的心电图异常，见于4例（13.3%）。15例（50%）患者进行了经静脉临时起搏器植入（TPI）。进行TPI显著延长了住院时间（比值比1.85，95%置信区间1.06 - 3.21，P = 0.03）。该队列中的死亡率为2例（6.7%）。
在黄花夹竹桃中毒患者中，伴有心电图异常的电解质紊乱很常见。TPI延长了住院时间。需要进一步研究以了解临时起搏的指征并确定其对生存的影响。
