Intensive therapy for chloroquine poisoning. A review of 29 cases.

OBJECTIVE

To obtain a data base of the features of chloroquine poisoning and to assess existing intensive therapy for it.

DESIGN

Retrospective review of all confirmed cases of acute chloroquine poisoning admitted to intensive care between November 1990 and October 1994. All available records were scrutinised.

SETTING

The intensive care units of Harare Central and Parirenyatwa hospitals, which are referral centres in Harare.

PATIENTS

Selection of patients depended on positive confirmation of chloroquine ingestion. Cases of concomitant ingestion of other drug(s) were not excluded.

MAIN OUTCOME MEASURES

Cardiac arrest or not; death or survival to discharge from hospital.

MAIN RESULTS

Of a total of 29 patients, aged 16-51 years, 69% (20) were female and 31% (9) male. The commonest clinical features were respiratory failure, depressed level of consciousness, hypothermia, hypotension, cardiac arrest and hypokalaemia. Eleven patients had at least one cardiac arrest; 5 of these were successfully resuscitated. Management included gastric lavage, intravenous diazepam, mechanical ventilation when necessary, and occasionally inotropic infusions. Four patients suffered cardiac arrest during gastric lavage. There were 6 deaths (mortality 20.7%).

CONCLUSIONS

This study indicates the common clinical features of acute chloroquine poisoning. A survival rate of about 80% is being achieved by intensive therapy at Harare Central and Parirenyatwa Hospitals. Rapid utilisation of the treatment regimen described should reduce the mortality to less than 10%.