Investigating Deaths among Mechanically Ventilated Acutely Poisoned Patients Admitted to Poison Control Center of Ain Shams University Hospitals from January to December 2013

Abstract

Mechanical ventilation is a cornerstone in the rescue and maintenance of patients with acute poisoning (Rosengart and Pinsky, 2014). In Egypt, the reports published by the Poison Control Center of Ain Shams University Hospitals (PCCA) during the year 2012 showed that 42% of overall acutely poisoned mechanically ventilated patients died, but it did not clarify whether deaths were related to the mechanical ventilation or not (El Masry and Tawfik, 2013). This gaveus imptus to investigate deaths among poisoned mechanically ventilated patients to recognize actual causes of these deaths.This study was designed so thatfiles of mechanically ventilated acutely poisoned patients who were reported dead on discharge were meticulously examined . Retrieved data were tabulated and statistically analyzed. As regard age of affected patients , no specific age prediction was observed.This study revealed that the highest incidence of died acutely poisoned mechanically ventilated admitted to ICU was observed in patient ranging between4 months to73 years,with mean age less than 25 years of whom male sex represented the majoritywith percentage 57.1% of cases. Attempting suicide was the main etiology of these cases. Majority of patients consumed the poison through oral route. In the majority of cases delay time to clinical presentation was less than 6 hours. The study also revealed that unemployment among middle aged males was prevailing among the died poisoned mechanically ventilated patients a matter which could be explained by their despirate attempts of suicide by taking serious toxic doses of the poison. Solving the problem of unemploymed by arrangement of some sort of social and psychological support and offering job opportunities for people suffering from unemployment may help reducing numbers of these deaths . Organophosphorus compounds (41.3%) and tramadol (23.8%), were the most frequently encountered agents of died acutely poisoned mechanically ventilated patients. OPI represented the majority of cases and this could be attributed to the fact that OPI is widely available and is used as insecticides in agriculture as well as for house-hold purposes and many OPC in the market are unknown or not registered or license. Accordingly substitution of the harmful insecticides by more safe or natural compounds and limitation of their use may be crucial.