Clinical efficacy of the atropine and pralidoxime treatment combined with hemoperfusion in patients with acute organophosphate pesticide poisoning

TL;DR

This study examines how combining hemoperfusion with atropine and pralidoxime affects treatment outcomes in patients poisoned by organophosphate pesticides.

Contribution

The study evaluates the clinical benefits of adding hemoperfusion to standard treatment for acute organophosphate pesticide poisoning.

Findings

Hemoperfusion combined with standard treatment reduced atropine conversion time and dosage.

The treatment improved acetylcholinesterase recovery time and APACHE-II scores.

Myocardial enzymes and inflammation levels were significantly lower in the hemoperfusion group.

Abstract

To explore the clinical efficacy of hemoperfusion (HP) combined with atropine and pralidoxime treatment in patients with acute organophosphate pesticide poisoning (AOPP).

This retrospective analysis included clinical data of 64 patients with AOPP admitted to Yongkang First People’s Hospital from October 2020 to January 2024. Among them, 32 patients were treated with atropine and pralidoxime (control group); 32 cases were treated with HP combined with atropine and pralidoxime (HP group). The primary outcomes were the required atropine conversion time, atropine dose, acetylcholinesterase (AchE) recovery time, Acute Physiology and Chronic Health Evaluation II (APACHE II) score at the time of atropine conversion, and in-hospital mortality rate. The secondary outcomes included changes in myocardial enzyme spectrum and inflammation levels.

The atropine conversion time, AchE recovery time, atropine dosage, and APACHE-II score during atropine conversion were significantly lower in the HP group than in the control group (P<0.05). However, there was no significant difference in mortality rate between the two groups during hospitalization (P>0.05). After treatment, the levels of myocardial enzymes and inflammation in the HP group were significantly lower compared to the control group (P<0.05).

HP in combination with atropine and pralidoxime in the treatment of AOPP can achieve higher benefits during atropine conversion in terms of atropine conversion time, AchE recovery time, and atropine dosage and is associated with a better APACHE-II score. This regimen can significantly downregulate the expression of myocardial enzymes and inflammatory factors.