Weaning was performed using either T-tube trials or pressure support weaning.

Positive end expiratory pressure was titrated to keep SaO 2 above 94% with 40% FIO 2.

Mechanical ventilation was performed as synchronized intermittent mandatory ventilation + pressure support mode, either as volume or pressure control. The patients were intubated and mechanically ventilated if the patients had respiratory failure, a depressed level of consciousness, which causes an inability to protect the airway, and hemodynamic instability. Other measures for the treatment were gastric lavage and administration of activated charcoal via nasogastric tube, and cleansing the patient's body with soap and water. Pralidoxime could not be given to 16 patients: 2 patients did not receive pralidoxime because they were late admissions and 14 did not receive pralidoxime because the Ministry of Health office was out of stock. Intravenous atropine and pralidoxime was administered as soon as possible. Diagnosis could not be confirmed with serum and red blood cell anticholinesterase levels because these are not performed at our institution. Diagnosis was performed from the history taken either from the patient or from the patient's relatives about the agent involved in the exposure. MethodsĪ retrospective study was performed on the patients with OP poisoning followed at our medical intensive care unit. We report our experience with the intensive care management of serious OP insecticide poisonings. The clinical course of OP poisoning may be quite severe and may need intensive care management. Treatment of OP poisoning consists of intravenous atropine and oximes. Early diagnosis and appropriate treatment is often life saving. The mortality rate of OP poisoning is high. The inhibition of acetylcholinesterase causes accumulation of acetylcholine at synapses, and overstimulation of neurotransmission occurs as a result of this accumulation. Organophosphate (OP) insecticides inhibit both cholinesterase and pseudo-cholinesterase activities.

Antidote for organophosphate poisoning