Comparison of therapeutic effects of single and multiple hemoperfusion on severe acute organophosphorus poisoning

Objective To compare the clinical efficacy of hemoperfusion (HP) times in patients with severe acute organophosphorus poisoning. Methods Eighty-six patients with severe acute organophosphorus poisoning (AOPP) admitted to intensive care unit from January 2014 to July 2018 were divided into 3 groups basing on times of hemoperfusion (HP), including a HP0 group of 26 cases received no hemoperfusion treatment, a HP1 group of 31 cases received once hemoperfusion treatment, and a HP2 of 29 cases received twice or more hemoperfusion treatments. Then the total dose of atropine and pralidoxime, recovery of 80% serum cholinesterase activity, duration of coma, hospital stay, time of mechanical ventilation, acute physiology and chronic health status scoring system Ⅱ (APACHE Ⅱ) score at 72 h after admission, and incidence of complications (intermediate syndrome, poisoning rebound, arrhythmia, organ dysfunction syndrome) and mortality of the 3 groups were compared. Results Hemoperfusion treatment was correlated with total dose of atropine and pralidoxime, recovery of 80% serum cholinesterase activity, duration of coma, hospital stay, time of mechanical ventilation, acute physiology and chronic health status scoring system Ⅱ (APACHE Ⅱ) score at 72 h after admission, the incidence of complications (intermediate syndrome, poisoning rebound, organ dysfunction syndrome) in HP2 was less than the others and mortality (P<0.05 for all), the incidence of arrhythmia in HP1 and HP2 was less than the HP0. Conclusion Multiple times of hemoperfusion is a supplement to conventional treatment showed significant efficacy for AOPP patients.