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

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

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).