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Korean Paper Presentation 3: Resuscitation/Airway Management Trauma, Toxicology/Environmental Emergency : OK3-3 ; Initial Serum Ammonia as Predictor for Severe Complications in Glufosinate Poisoning
( Yoon Suk Lee ) , ( Dong Geon Lee ) , ( Yong Sung Cha ) , ( Hyun Kim ) , ( Jin Go ) , ( Tae Hoon Kim ) , ( Oh Hyun Kim ) , ( Kyoung Chul Cha ) , ( Kang Hyun Lee ) , ( Sung Oh Hwang )
UCI I410-ECN-0102-2015-500-002059663
This article is 4 pages or less.
* This article is free of use.

Glufosinate poisoning can cause severe complications at initial and also delayed manifestation of severe complications can make a treating glufosinate poisoned patients difficult. However, there are only few study about predictors for the serious complications and especially for the serum ammonia level, only case reports have been presented as a probable predictor of severe neurotoxicity. Therefore, we investigated the general characteristics, clinical presentations, and the factors that can predict severe complications in glufosinate poisoned patients. We conducted a retrospective review of 45 consecutive glufosinate poisoning cases that were diagnosed and treated at the emergency department of the Wonju Severance Christian Hospital between May 2007 and July 2014. The patients were divided into two groups: severe and non-severe group. The severe group is defined as patients with life threatening conditions (GCS <8, seizure, respiratory failure, and hypotension) Severe group were 29 patients (64.4%). Clinical courses included severe group after glufosinate poisoning were GCS <8 (27 patients, 60.0%), seizure (23 patients, 51.1%), respiratory failure (14 patients, 31.1%), and hypotension (2 patients, 4.4%). GCS <8, seizure, and respiratory failure, which are severe complications, appeared with latent period within 14 hrs, 34 hrs, and 14 hrs, respectively. The predicting factor of severe complications was initial serum ammonia. The optimal point of initial serum ammonia was 86 ug/dL [sensitivity: 72%, specificity: 64%, and area under the curve (AUC) 0.742]. Severe complications, such as GCS <8, seizure, respiratory failure, and hypotension, developed in 64.4% of glufosinate poisoning. The most common severe complication was GCS <8. The predictor of severe complications included initial serum ammonia level > 86 ug/dL.

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