Ibrahim Anastasia E, Ghantarchyan Henrik, Le Thucminh, Bhagat Ankur, Maknouni Bahareh, Arabian Sarkis
Intensive Care Unit, Arrowhead Regional Medical Center, Colton, USA.
Internal Medicine, Arrowhead Regional Medical Center, Colton, USA.
Cureus. 2022 Nov 14;14(11):e31497. doi: 10.7759/cureus.31497. eCollection 2022 Nov.
Organophosphates are chemicals commonly used as pesticides and work to inhibit acetylcholinesterase, leading to acetylcholine build up at muscarinic and nicotinic receptors throughout the body. Poisonings are often seen as small volume, chronic cases due to agricultural exposures, but can present as suicide attempts via organophosphate ingestion. Organophosphate poisonings, particularly when large volumes are ingested, require rapid and robust initiation of treatment. We present a case highlighting the appropriate management of profound organophosphate toxicity. We present a case of a 40-year-old female brought in by ambulance after purposefully ingesting two bottles of 100mL dichlorvos (DDVP), one of the largest volume organophosphate ingestions documented in the literature. She presented with severe salivation, diaphoresis and encephalopathy and was then intubated, requiring mechanical ventilation. She received multiple days of intensive care as she was treated with atropine, pralidoxime, intravenous fluids and vasopressors.
有机磷酸酯是常用作杀虫剂的化学品，其作用是抑制乙酰胆碱酯酶，导致乙酰胆碱在全身的毒蕈碱受体和烟碱受体处蓄积。中毒常见于因农业接触导致的小剂量、慢性病例，但也可能表现为通过摄入有机磷酸酯进行自杀的企图。有机磷酸酯中毒，尤其是大量摄入时，需要迅速且有力地开始治疗。我们报告一例突出显示对严重有机磷酸酯毒性进行恰当处理的病例。我们报告一例40岁女性，在故意摄入两瓶100毫升敌敌畏（DDVP）后由救护车送来，这是文献记载中最大量的有机磷酸酯摄入案例之一。她出现严重流涎、出汗和脑病，随后插管，需要机械通气。在接受阿托品、氯解磷定、静脉输液和血管加压药治疗期间，她接受了多天的重症监护。
