Clinical Toxicology
Zohreh Oghabian; Maral Ramezani; Shahin Shadnia; Farah Pouramiri; Babak Mostafazadeh; Masoomeh Varzandeh; Peyman Erfan Talab Evini; Shahrad Tajaddini; Mitra Rahimi
Volume 10, Issue 1 , January 2024, , Pages 82-87
Abstract
Objective: Paraquat poisoning is a critical condition with a high mortality rate, and there are currently no established treatment guidelines for managing this toxin. Hemoperfusion constitutes an alternative treatment for paraquat poisoning. This study aimed to evaluate the efficacy of hemoperfusion ...
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Objective: Paraquat poisoning is a critical condition with a high mortality rate, and there are currently no established treatment guidelines for managing this toxin. Hemoperfusion constitutes an alternative treatment for paraquat poisoning. This study aimed to evaluate the efficacy of hemoperfusion therapy using the Jafron HA330 hemoperfusion cartridge in patients with paraquat poisoning.Case Presentations: This case series study was conducted on paraquat poisoning patients in Tehran’s Loghman Hakim and Kerman’s Afzalipour hospitals. In addition to the standard treatment of poisoning patients, the patients underwent hemoperfusion using the HA330 cartridge three times at 24-hour intervals, each time lasting 180–240 minutes. Before and following the completion of the treatment program, patients’ information and laboratory results were meticulously documented. Statistical analysis was performed using SPSS software version 21. The study noted that eight of the nine patients passed away. A notable finding was the significant reduction in potassium levels in the blood. Seven patients required intubation. A notable reduction in hemoglobin levels was detected following treatment. Furthermore, a decline in bicarbonate and pH levels was observed in patients, in post-treatment, though this decrease did not attain statistical significance. Conversely, the total bilirubin levels exhibited an increase in patients following treatment; however, this change was not statistically significant.Conclusion: The findings of this study suggest that hemoperfusion with HA330 cartridges does not yield a substantial improvement in the survival of patients poisoned by paraquat.
Clinical Toxicology
Javad Mesbahi; Shahin Shadnia; Hossein Hassanian-Moghaddam; Nasim Zamani; Peyman Erfan Talab Evini; Delara Hazegh Fetratjoo; Alireza Kargar; Mitra Rahimi
Volume 7, Issue 2 , July 2021, , Pages 93-96
Abstract
Objective: Delirium is one of the most common complications in patients admittedto intensive care units (ICUs). Delirium is a definite cause for more extended hospitalstays, higher mortality rates, and possibly persistent cognitive decline in the future.Antipsychotics have been frequently evaluated as ...
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Objective: Delirium is one of the most common complications in patients admittedto intensive care units (ICUs). Delirium is a definite cause for more extended hospitalstays, higher mortality rates, and possibly persistent cognitive decline in the future.Antipsychotics have been frequently evaluated as first drugs of choice, but the mostappropriate, evidence-based treatment is yet to be discovered. This study aims to comparethe efficacy of haloperidol and olanzapine in patients admitted to our toxicology ICU.Methods: This double-blind, randomized controlled clinical trial was undertaken on 35 ICUadmitted patients with delirium in Loghman Hakim hospital in Tehran, Iran. The diagnosiswas based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition(DSM-V) criteria for delirium, and clinical toxicologists included the patients accordingto the study’s inclusion and exclusion criteria. Patients received either haloperidol orolanzapine based on computerized randomization. The severity of delirium was measuredwith the Memorial Delirium Assessment Scale (MDAS) scoring on days 0 and 3 of ICUadmission.Results: The total sample size was 35 in which 16 patients received haloperidol, and 19patients received olanzapine. The doses of haloperidol and olanzapine were 3 mg threetimes a day and 5 mg three times a day, respectively. There was no significant difference inbaseline characteristics and the scores of MDAS between groups.Conclusion: Olanzapine and haloperidol have the same efficacy in the managementof delirium in toxicology ICU-admitted patients. They can be interchangeably used fordelirium treatment in these patients