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ORIGINAL ARTICLE
Year : 2017  |  Volume : 45  |  Issue : 4  |  Page : 181-191

A randomized clinical trial to evaluate the efficacy of single versus multiple gastric lavage in the management of patients with acute organophosphorus poisoning


1 Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Department of Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta, Egypt
3 Toxicologist and Forensic Chemistry Expert, Forensic Medicine Institute

Correspondence Address:
Shaimaa A.M El-Gendy
Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Tanta University, Tanta
Egypt
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DOI: 10.4103/tmj.tmj_23_17

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Background Despite lack of supporting evidence gastric lavage (GL) is one of the most commonly used decontamination method for organophosphorus (OP) ingestion in developing countries. Aim This study was designed to evaluate the outcome of patients with OP pesticide poisoning treated with GL with regard to timing and frequency of the procedure. Patients and methods In this study, GL was planned to be administered to patients with OP pesticide poisoning after initial stabilization irrespective of lavage given in peripheral hospitals. Therefore, some patients received one procedure (single GL) and some received more than one procedure (multiple GL). Early GL was defined as GL given within 2 h of poison exposure and late GL was referred to performing the procedure after 2 h. Results During the study period, 40 patients with OP pesticide poisoning received GL comprising 11 who received early single, nine who received late single, 10 who received early multiple and 10 who received late multiple GL. Mortality, respiratory failure incidence, ICU admission and incidence of mechanical ventilation (MV) were not significantly different between patients receiving early single, late single, early multiple and late multiple GL. There was significant difference between patients who received early single, late single, early multiple and late multiple GL regarding the duration of MV, hospital stay duration, and atropine and oximes ampoules needed. Conclusion Multiple GL created insignificant reduction in overall mortality from OP poisoning; yet early and multiple GL proved to be more effective than single GL in reducing the incidence of respiratory failure, ICU admission and MV and in decreasing hospital stay duration and atropine and oximes therapy amount significantly.


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