Volume 5 Supplement 1

21st International Symposium on Intensive Care and Emergency Medicine

Open Access

End-tidal CO2 (EtCO2) and QTc period: can it help us in the prognosis of patients with organophosphate poisoning?

  • S Grmec1,
  • S Mally1 and
  • P Klemen1
Critical Care20015(Suppl 1):P205

DOI: 10.1186/cc1272

Received: 15 January 2001

Published: 2 March 2001

Introduction

In our area, organophosphate poisoning is a frequent method of commiting suicide, with a relatively high mortality rate (12–16%, data from literature). Defining and observing the QTc period and EtCO2 enables us to make an additional estimate of the handicap and prognosis, or better the possibility of complications (respiratory failure).

Methods

The contribution presents our experience in the period from February 1997 to September 2000. During this period, either in the emergency ward or during interventions we met 61 patients (37 male and 24 female; age varied from 18 to 75 years with a mean 57.4 ± 18.3), for whom the diagnosis organophosphate poisoning was confirmed by means of anamnesis/heteroanamnesis and laboratory analysis (serum cholinesterase). In prehospital setting we collected from each patient EtCO2, SaO2, QTc period, pre- and postintervention values of the MEES. The APACHE II score was recorded on the day of admission to the hospital. We compared two groups (with complications [group I] and without complications [group II]). A P value < 0.05 was chosen to rejected null hypothesis.

Results

See Table.

Table

 

Group I

Group II

P value

End-tidal CO2 (mmHg)

38.3 ± 8.5

56.4 ± 10.3

< 0.05*

SaO2 (%)

75.3 ± 9.2

89.5 ± 6.3

< 0.05*

QTc (s)

0.69 ± 0.17

0.45 ± 0.11

< 0.05*

MEES (postintub.)

18.3 ± 6.1

22.4 ± 3.3

< 0.05*

APACHE II

32.7 ± 9.4

20.6 ± 5.8

< 0.05*

Intubation-Y/N

22/7

11/21

< 0.05

Ratio dead/survive

11/19

3/28

< 0.05

* Student's t-test; Χ2 test.

Conclusion

In the initial nursing of patients with organophosphate poisoning, monitoring (ECG, capnometry) and observation of the QTc period and EtCO2 is essential, for it helps us in the prognosis of the patient and suggests precaution due to the danger of complications (respiratory failure).

Authors’ Affiliations

(1)
PHU Maribor

Copyright

© The Author(s) 2001

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