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Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning
BACKGROUND: Organophosphorus (OP) and carbamate pesticides are widely used for crop protection. We describe the spectrum of laryngeal abnormalities in patients admitted to the intensive care unit (ICU) with acute OP and carbamate poisoning as there is limited information on it. MATERIALS AND METHODS...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Jaypee Brothers Medical Publishers
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857705/ https://www.ncbi.nlm.nih.gov/pubmed/35712737 http://dx.doi.org/10.5005/jp-journals-10071-24096 |
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author | Mani, Gajalakshmi S Mathews, Suma S Victor, Punitha Peter, John V Yadav, Bijesh Albert, Rita RA |
author_facet | Mani, Gajalakshmi S Mathews, Suma S Victor, Punitha Peter, John V Yadav, Bijesh Albert, Rita RA |
author_sort | Mani, Gajalakshmi S |
collection | PubMed |
description | BACKGROUND: Organophosphorus (OP) and carbamate pesticides are widely used for crop protection. We describe the spectrum of laryngeal abnormalities in patients admitted to the intensive care unit (ICU) with acute OP and carbamate poisoning as there is limited information on it. MATERIALS AND METHODS: Consecutive patients admitted to the ICU with acute OP and carbamate poisoning over 20 months (December 2014–July 2016) were recruited. Patients were followed up post-discharge if they had undergone tracheostomy or developed hoarseness of voice or stridor following extubation. Asymptomatic individuals who consented underwent laryngoscopy after ICU discharge. The primary outcome was the development of laryngeal dysfunction. Other outcomes included length of stay, need for ventilation, mortality, tracheostomy, and time to decannulation of tracheostomy. RESULTS: Of the 136 patients recruited, 71 (52%) underwent laryngoscopy. The overall mortality rate was 9.6%. Of the 71 patients who underwent laryngoscopy, 18 had abnormal findings, which included unilateral or bilateral vocal cord paresis or palsy (n = 14) and/or aspiration (n = 9), subglottic stenosis (n = 1), tracheal stenosis (n = 1), or arytenoid granuloma (n = 1). Laryngeal dysfunction was associated with the ingestion of a dimethyl OP compound (p = 0.04) and quantum consumed (p <0.001). Patients with laryngeal dysfunction had significantly (p = 0.004) longer hospital stay (19.1 ± 10.7 vs 11.8 ± 8.3 days). CONCLUSION: Laryngeal dysfunction is not uncommon in OP and carbamate poisoning and is associated with the ingestion of larger quantity of a dimethyl OP compound and longer hospital stay. Otorhinolaryngologists could be involved early to help identify these abnormalities and initiate an appropriate treatment to ensure a functional voice and good airway. HOW TO CITE THIS ARTICLE: Mani GS, Mathews SS, Victor P, Peter JV, Yadav B, Albert RRA. Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning. Indian J Crit Care Med 2022;26(2):167–173. |
format | Online Article Text |
id | pubmed-8857705 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Jaypee Brothers Medical Publishers |
record_format | MEDLINE/PubMed |
spelling | pubmed-88577052022-06-15 Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning Mani, Gajalakshmi S Mathews, Suma S Victor, Punitha Peter, John V Yadav, Bijesh Albert, Rita RA Indian J Crit Care Med Original Article BACKGROUND: Organophosphorus (OP) and carbamate pesticides are widely used for crop protection. We describe the spectrum of laryngeal abnormalities in patients admitted to the intensive care unit (ICU) with acute OP and carbamate poisoning as there is limited information on it. MATERIALS AND METHODS: Consecutive patients admitted to the ICU with acute OP and carbamate poisoning over 20 months (December 2014–July 2016) were recruited. Patients were followed up post-discharge if they had undergone tracheostomy or developed hoarseness of voice or stridor following extubation. Asymptomatic individuals who consented underwent laryngoscopy after ICU discharge. The primary outcome was the development of laryngeal dysfunction. Other outcomes included length of stay, need for ventilation, mortality, tracheostomy, and time to decannulation of tracheostomy. RESULTS: Of the 136 patients recruited, 71 (52%) underwent laryngoscopy. The overall mortality rate was 9.6%. Of the 71 patients who underwent laryngoscopy, 18 had abnormal findings, which included unilateral or bilateral vocal cord paresis or palsy (n = 14) and/or aspiration (n = 9), subglottic stenosis (n = 1), tracheal stenosis (n = 1), or arytenoid granuloma (n = 1). Laryngeal dysfunction was associated with the ingestion of a dimethyl OP compound (p = 0.04) and quantum consumed (p <0.001). Patients with laryngeal dysfunction had significantly (p = 0.004) longer hospital stay (19.1 ± 10.7 vs 11.8 ± 8.3 days). CONCLUSION: Laryngeal dysfunction is not uncommon in OP and carbamate poisoning and is associated with the ingestion of larger quantity of a dimethyl OP compound and longer hospital stay. Otorhinolaryngologists could be involved early to help identify these abnormalities and initiate an appropriate treatment to ensure a functional voice and good airway. HOW TO CITE THIS ARTICLE: Mani GS, Mathews SS, Victor P, Peter JV, Yadav B, Albert RRA. Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning. Indian J Crit Care Med 2022;26(2):167–173. Jaypee Brothers Medical Publishers 2022-02 /pmc/articles/PMC8857705/ /pubmed/35712737 http://dx.doi.org/10.5005/jp-journals-10071-24096 Text en Copyright © 2022; The Author(s). https://creativecommons.org/licenses/by-nc/4.0/© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Original Article Mani, Gajalakshmi S Mathews, Suma S Victor, Punitha Peter, John V Yadav, Bijesh Albert, Rita RA Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning |
title | Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning |
title_full | Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning |
title_fullStr | Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning |
title_full_unstemmed | Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning |
title_short | Laryngeal Dysfunction in Acute Organophosphorus and Carbamate Poisoning |
title_sort | laryngeal dysfunction in acute organophosphorus and carbamate poisoning |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857705/ https://www.ncbi.nlm.nih.gov/pubmed/35712737 http://dx.doi.org/10.5005/jp-journals-10071-24096 |
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