Sanga Lalhming, Jacob Amita, Jayakaran Jonathan Arul Jeevan, Iyadurai Ramya
Department of Medicine, Christian Hospital Serkawn, Lunglei, Mizoram, India.
Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Indian J Crit Care Med. 2024 Jan;28(1):66-69. doi: 10.5005/jp-journals-10071-24599.
Neonicotinoids are a newer class of pesticides that are believed to cause predominantly mild toxicity in humans. This study aimed to describe the clinical features of neonicotinoid poisoning and identify predictors of severe toxicity.
This retrospective study included all patients with neonicotinoid poisoning admitted to a Tertiary Care Center in India over an 18-year period. Clinical and laboratory features were compared against outcomes to identify predictors of the need for intensive care admission.
Twenty-eight patients were included in the study of which 28.6% had severe disease requiring ICU admission. A higher respiratory rate, blood lactate level, SOFA, and qSOFA scores as well as a lower Glasgow coma score at presentation predicted ICU admission. First-generation compounds and imidacloprid consumption were associated with longer ICU stays and a longer duration of invasive ventilation.
Neonicotinoid compounds can cause significant toxicity with oral ingestion. Imidacloprid and other first-generation compounds were associated with more severe toxicity requiring intensive care. Simple clinical parameters assessed at presentation can be used to predict severe disease and the need for ICU care. Larger, prospective studies are required to confirm these findings.
Sanga L, Jacob A, Jayakaran JAJ, Iyadurai R. Clinical Profile and Predictors of Intensive Care Admission in Neonicotinoid Poisoning in a Tertiary Care Hospital in South India. Indian J Crit Care Med 2024;28(1):66-69.
新烟碱类是一类新型杀虫剂,据信对人类主要造成轻度毒性。本研究旨在描述新烟碱类中毒的临床特征,并确定严重毒性的预测因素。
这项回顾性研究纳入了印度一家三级护理中心18年间收治的所有新烟碱类中毒患者。将临床和实验室特征与结局进行比较,以确定入住重症监护病房的预测因素。
该研究纳入了28例患者,其中28.6%患有严重疾病,需要入住重症监护病房。较高的呼吸频率、血乳酸水平、序贯器官衰竭评估(SOFA)和快速序贯器官衰竭评估(qSOFA)评分,以及入院时较低的格拉斯哥昏迷评分可预测入住重症监护病房。第一代化合物和吡虫啉的摄入与重症监护病房住院时间延长和有创通气时间延长有关。
口服新烟碱类化合物可导致显著毒性。吡虫啉和其他第一代化合物与更严重的毒性有关,需要重症监护。入院时评估的简单临床参数可用于预测严重疾病和重症监护需求。需要更大规模的前瞻性研究来证实这些发现。
桑加L、雅各布A、贾亚卡兰JAJ、伊亚杜拉伊R。印度南部一家三级护理医院新烟碱类中毒患者的临床特征及重症监护入院预测因素。《印度重症医学杂志》2024;28(1):66 - 69。