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Wang P, Song C, Lu X, Lu Y. Seizure as the main presenting manifestation of three patients with acute glufosinate-ammonium poisoning. J Zhejiang Univ Sci B 2024; 25:354-358. [PMID: 38584096 PMCID: PMC11009438 DOI: 10.1631/jzus.b2300469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/03/2023] [Indexed: 04/09/2024]
Abstract
Glufosinate-ammonium herbicides are the most widely used broad-spectrum, non-selective herbicides in the world. Glufosinate-ammonium is a structural analogue of glutamate (Glu) which can irreversibly inhibit the activity of glutamine synthetase (GS) and Glu decarboxylase in plants, thereby blocking the synthesis of glutamine (Gln) from Glu and ammonia (Hoerlein, 1994). This causes the plants to die because of the nitrogen metabolism disorder and subsequent intracellular accumulation of ammonia. In humans, the characteristic features of glufosinate-ammonium herbicide poisoning include gastrointestinal symptoms and neurotoxicity (Watanabe and Sano, 1998). Currently, there are no antidotes for glufosinate-ammonium herbicide poisoning, and thus supportive care is the key treatment.
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Affiliation(s)
- Ping Wang
- Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
- Zhejiang Key Laboratory for Diagnosis and Treatment of Physic-chemical and Aging-related Injuries, Hangzhou 310003, China
| | - Congying Song
- Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
- Zhejiang Key Laboratory for Diagnosis and Treatment of Physic-chemical and Aging-related Injuries, Hangzhou 310003, China
| | - Xuan Lu
- Zhejiang Key Laboratory for Diagnosis and Treatment of Physic-chemical and Aging-related Injuries, Hangzhou 310003, China
- Department of Geriatric Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China
| | - Yuanqiang Lu
- Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
- Zhejiang Key Laboratory for Diagnosis and Treatment of Physic-chemical and Aging-related Injuries, Hangzhou 310003, China.
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The trend of ammonia levels in patients with glufosinate ammonium poisoning with respect to neurotoxicity. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:525-531. [PMID: 36399183 DOI: 10.1007/s00210-022-02327-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
Since glufosinate irreversibly inhibits glutamine synthetase, leading to intracellular accumulation of ammonia, hyperammonemia is considered one of the main mechanisms of glufosinate ammonium toxicity in humans. However, whether hyperammonemia causes neurotoxicity has not yet been studied. Therefore, the purpose of this study was to determine whether the serum ammonia level is elevated before the development of neurotoxicity. In this retrospective observational study, we analyzed data from consecutive patients diagnosed with acute glufosinate ammonium poisoning. The primary outcome was the development of neurotoxicity following the poisoning. Patients who developed neurotoxicity were characterized by higher initial ammonia levels compared to patients without neurotoxicity (121.0 µg/dL [87.0; 141.0] vs 83.0 µg/dL [65.0; 119.0], p < 0.01). However, there was no increase in ammonia levels over time in both the asymptomatic and neurotoxicity groups when serial serum ammonia levels were examined from emergency department admission to hospital discharge. In addition, there was no statistically significant difference between the peak ammonia levels in the asymptomatic group and the peak ammonia levels before symptom onset in the neurotoxicity group (135.0 µg/dL [109.0; 158.0] vs 144.0 µg/dL [120.0; 189.0], p = 0.15). Following the onset of neurotoxicity, the serum ammonia level increased significantly (125.0 [111.0; 151.0] µg/dL to 148.0 [118.0; 183.0] µg/dL, p < 0.01). In conclusion, hyperammonemia cannot be assumed as the cause of neurotoxicity in glufosinate ammonium poisoning and further research is needed to examine the exact mechanism of GA poisoning.
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Dang DX, Li CJ, Cui Y, Zhou H, Lou Y, Li D. Egg quality, hatchability, gosling quality, and amino acid profile in albumen and newly-hatched goslings' serum as affected by egg storage. Poult Sci 2022; 102:102367. [PMID: 36780703 PMCID: PMC9947414 DOI: 10.1016/j.psj.2022.102367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 12/03/2022] Open
Abstract
In modern poultry husbandry, storing fertilized eggs is a common measure to cope with the variable demands of the market and the maximum hatching capacity of the hatchery. However, this measure is harmful to the hatchability of eggs and the quality of newly hatched birds. Knowledge about the effects of storing fertilized eggs on the performance of goslings is still limited. The objective of this study was to investigate the effects of storing fertilized eggs on egg quality, hatchability, gosling quality, hatching weight, post-hatching growth performance, and amino acid profile in albumen and newly hatched goslings' serum. A total of 1,080 fertilized goose eggs (Jilin White goose) with a similar egg weight (126.56 ± 0.66 g) were used in this study. All eggs were distributed into 3 groups with 24 replicates per group and 15 eggs per replicate. The differences between groups were the storage duration of eggs (0, 7, or 14 d). We found that the Haugh unit, yolk weight, and eggshell weight decreased linearly, whereas the albumen pH increased linearly, with storage duration. Prolonging storage duration had negative effects on hatchability, hatching weight, post-hatching growth performance parameters, and gosling quality in a time-dependent manner. The analysis of the amino acid profile in albumen and newly-hatched goslings' serum showed that the amino acid content increased linearly with storage duration. Additionally, eggs stored for 14 d had the worst performance for all measured parameters. Therefore, we concluded that the storage of fertilized eggs negatively affects egg quality and post-hatching gosling quality. To produce high-quality goslings, it is necessary to shorten the storage duration for fertilized eggs.
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Affiliation(s)
- De Xin Dang
- College of Animal Science and Veterinary Medicine, Jinzhou Medical University, Jinzhou 121001, China,Department of Animal Resources Science, Dankook University, Cheonan 31116, South Korea
| | - Cheng Ji Li
- Institute of Tissue Regeneration Engineering, Dankook University, Cheonan 31116, South Korea,Department of Nanobiomedical Science and BK21 PLUS NBM Global Research Center for Regenerative Medicine, Dankook University, Cheonan, 31116, South Korea
| | - Yan Cui
- College of Animal Science and Veterinary Medicine, Jinzhou Medical University, Jinzhou 121001, China
| | - Haizhu Zhou
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin, China
| | - Yujie Lou
- College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin, China
| | - Desheng Li
- College of Animal Science and Veterinary Medicine, Jinzhou Medical University, Jinzhou 121001, China.
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Kim J, Chun BJ, Moon JM, Cho Y. Prognostic value of neutrophil to lymphocyte ratio in the diagnosis of neurotoxicity after glufosinate ammonium poisoning. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2022; 85:511-519. [PMID: 35164661 DOI: 10.1080/15287394.2022.2040670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Neurotoxicity related to glufosinate ammonium is known to occur after a latent period of 4-60 hr following ingestion of this herbicide. However, neurotoxicity is difficult to predict in the emergency department (ED) and only a few parameters are known to be useful to indicate development of neurotoxicity. Determination of a systemic inflammation parameter such as the neutrophil to lymphocyte ratio (NLR), is a rapid and simple method which was found to be a prognostic marker in various clinical conditions such as sepsis, cardiac disorders, stroke, and cancer. Therefore, the aim of this study was to determine whether the NLR might predict neurotoxicity and be used at ED to detect neurotoxicity induced following glufosinate ammonium poisoning in admitted patients. This retrospective observational study collected data from consecutive patients diagnosed with acute glufosinate ammonium poisoning between January 2005 and December 2020. The primary outcome was development of neurotoxicity following acute glufosinate ammonium poisoning. Out of the 72 patients selected 44 patients (61.1%) exhibited neurotoxic symptoms. Neurotoxicity appeared with an approximate latent period of 12 hr. The NLR was significantly higher in the group displaying neurotoxicity. Multivariable analysis showed that the NLR was significant in predicting neurotoxicity. The NLR was independently associated with neurotoxicity initiated by glufosinate ammonium. Therefore, the use of the NLR might help clinically to readily and rapidly predict development of neurotoxicity associated with glufosinate ammonium at the ED.
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Affiliation(s)
- Joochan Kim
- Department of Medicine, Chonnam National University, Buk-gu, Gwangju, Republic of Korea
| | - Byeong Jo Chun
- Department of Medicine, Chonnam National University, Buk-gu, Gwangju, Republic of Korea
| | - Jeong Mi Moon
- Department of Medicine, Chonnam National University, Buk-gu, Gwangju, Republic of Korea
| | - Yongsoo Cho
- Department of Medicine, Chonnam National University, Buk-gu, Gwangju, Republic of Korea
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Hsiao JT, Pan HY, Kung CT, Cheng FJ, Chuang PC. Assessment of glufosinate-containing herbicide exposure: A multi-center retrospective study. Am J Emerg Med 2021; 50:232-236. [PMID: 34392143 DOI: 10.1016/j.ajem.2021.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Exposure to glufosinate ammonium, an herbicide used worldwide, can cause CNS and respiratory toxicities. This study aimed to analyze acute human glufosinate ammonium poisoning. MATERIALS AND METHODS This multicenter retrospective cohort study involved five medical institutes affiliated with the Chang Gung Memorial Hospital system. Patients with glufosinate ammonium exposure visiting the emergency department (ED) between January 2008 and December 2020 were included. RESULTS In total, 95 patients were enrolled. Compared to exposure via the non-oral route, patients exposed orally (n = 61) had lower GCS scores, higher mortality rates, and longer hospital lengths of stay (P-value: <0.001, 0.002, and < 0.001, respectively). In the subgroup analysis among oral exposure patients, the survival group had a lower amount of estimated glufosinate ingestion than the non-survival group (10.5 [3.4-27] vs. 40.5 [27-47.3] g, P-value: 0.022), lower rate of substance co-exposure (9 [19.6%] vs. 10 [66.7%] P-value: 0.001), and lower rate of paraquat co-exposure (0 [0%] vs. 7 [46.7%] P < 0.001) compared with the mortality group. In the orally-exposed and non-paraquat co-exposure patients (n = 54), age > 70 years and GCS score < 9 at triage presented a high sensitivity (100.00%, 95% CI: 63.06-100.00%) and medium specificity (58.70%, 95% CI: 43.23-73.00%) in predicting mortality. CONCLUSION Old age, change in consciousness, and paraquat co-exposure were associated with higher mortality in human glufosinate poisoning. Age > 70 years and GCS score < 9 at triage could be predictors of mortality in patients with acute oral glufosinate poisoning.
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Affiliation(s)
- Jen-Tso Hsiao
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan
| | - Hsiu-Yung Pan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan; Chang Gung University College of Medicine, Guishan District, Taoyuan City, Taiwan
| | - Chia-Te Kung
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan; Chang Gung University College of Medicine, Guishan District, Taoyuan City, Taiwan.
| | - Fu-Jen Cheng
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan; Chang Gung University College of Medicine, Guishan District, Taoyuan City, Taiwan.
| | - Po-Chun Chuang
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan; Chang Gung University College of Medicine, Guishan District, Taoyuan City, Taiwan.
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Yeon S, Kim SH, Sim J, Kim S, Lee Y, Kim H, Cha YS. Major component causing neurological toxicity in acute glufosinate ammonium poisoning: determination of glufosinate, 1-methoxy-2-propanol, and ammonia in serum and cerebrospinal fluid. Clin Toxicol (Phila) 2021; 60:286-292. [PMID: 34269144 DOI: 10.1080/15563650.2021.1952215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the primary contributor to neurotoxicity in patients with glufosinate ammonium (GLA) poisoning, by quantifying glufosinate, 1-methoxy-2-propanol, and ammonia in serum and the cerebrospinal fluid (CSF). MATERIALS AND METHODS We collected and analysed data from confirmed cases of GLA poisoning between May 2018 and August 2020. Based on the occurrence of neurological complications (mental change, seizure, and central apnoea), patients were assigned to one of two groups: those with complications (NCx) and without (non-NCx) complications. Concentrations of glufosinate, 1-methoxy-2-propanol (1M2P), and ammonia were measured in the serum upon admission and during hospital stay. The concentrations of all these substances were again measured in the CSF following a decline in the mental status or seizure (NCx group) or on the day after hospitalisation (non-NCx group). RESULTS Of the 20 patients included, ammonia levels in the serum and CSF at onset of altered sensorium in the NCx group (n = 16) were significantly higher than those at one day after hospitalisation in the non-NCx group (n = 4) (p = 0.011 in serum, p = 0.047 in CSF), with its concentration in the CSF being higher than that in the serum in 15/16 cases. The concentration of 1M2P was similar in the serum and CSF (8/16), but the concentrations of glufosinate (7/16) was lower in the CSF than in the serum. In the non-NCx group (n = 4), only ammonia was detectable. CONCLUSIONS Among patients with GLA poisoning, increased CSF ammonia was significantly correlated with neurological complications.
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Affiliation(s)
- Seonghoon Yeon
- Forensic Toxicology Division, National Forensic Service, Wonju, Republic of Korea
| | - Sung Hwa Kim
- Department of Biostatistics and Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Juhyun Sim
- Forensic Toxicology Division, National Forensic Service, Wonju, Republic of Korea
| | - Sunchun Kim
- Forensic Toxicology Division, Daejeon institute, National Forensic Service, Daejeon, Republic of Korea
| | - Yoonsuk Lee
- Department of Emergency Medicine and Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hyun Kim
- Department of Emergency Medicine and Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Yong Sung Cha
- Department of Emergency Medicine and Research Institute of Hyperbaric Medicine and Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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Sevİm Ç, Taghİzadehghalehjoughİ A, Kara M. In Vitro Investigation of the Effects of Imidacloprid on AChE, LDH, and GSH Levels in the L-929 Fibroblast Cell Line. Turk J Pharm Sci 2020; 17:506-510. [PMID: 33177931 DOI: 10.4274/tjps.galenos.2019.15807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/29/2019] [Indexed: 12/01/2022]
Abstract
Objectives There are several types of pesticides to control pests and several new types coming into use that could be less toxic compared to the old ones. Pesticide-induced oxidative stress, which is one of the main mechanisms of toxicity, is the research area focused most on over the last decade. There are several different studies in the literature on whether pesticide exposure induces oxidative stress parameter-mediated toxicity. Pesticide-induced oxidative stress level depends on the biochemical features of mammalian systems. Imidacloprid is a neonicotinoid pesticide in wide use that is considered safe; however, it has been reported in different studies that it may cause changes in oxidative stress parameters. Materials and Methods We investigated the dose- and time-dependent effects of imidacloprid on acetylcholinesterase (AChE), lactate dehydrogenase (LDH), and glutathione (GSH) levels in the L-929 fibroblast cell line. The effects of 1-500 μg imidacloprid dose range on AChE, GSH, and LDH were investigated. Results LDH levels were significantly increased dose dependently in the 250 and 500 ng imidacloprid groups compared to the control group. GSH levels nonsignificantly decreased dose dependently and GSH levels were lower in the 500 ng imidacloprid group compared to the control group. There were no significant differences between the groups in AChE levels. Conclusion These results indicated that high doses of imidacloprid may induce oxidative stress in fibroblast cells.
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Affiliation(s)
- Çiğdem Sevİm
- İstanbul University Faculty of Pharmacy, Department of Pharmaceutical Toxicology, İstanbul, Turkey
| | | | - Mehtap Kara
- Atatürk University Veterinary Faculty, Department of Pharmacology and Toxicology, Erzurum, Turkey
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Dong T, Guan Q, Hu W, Zhang M, Zhang Y, Chen M, Wang X, Xia Y. Prenatal exposure to glufosinate ammonium disturbs gut microbiome and induces behavioral abnormalities in mice. JOURNAL OF HAZARDOUS MATERIALS 2020; 389:122152. [PMID: 32004847 DOI: 10.1016/j.jhazmat.2020.122152] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 01/19/2020] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
Glufosinate ammonium (GLA) is a widely used organophosphate herbicide, which could be commonly detected in body fluids of both pregnant women and newborns. Existing evidences indicate that GLA has reproductive toxicity, while data concerning the effects of prenatal GLA exposure on neurodevelopment is rather limited. Here we employed a mouse model exposed to GLA prenatally. Reduced locomotor activity, impaired memory formation and autism-like behaviors were observed in the treatment group. Marked alteration in gut microbiome of the treatment offspring mice could be found at 4th week, and seemed to recover over time. Fecal metabolomics analysis indicated remarkable changes in microbiome-related metabolism in the treatment group, which could be the cause of behavioral abnormality in mice. Present study suggested that prenatal exposure to GLA disturbed gut microbiome and metabolism, and thereby induced behavioral abnormalities in mice.
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Affiliation(s)
- Tianyu Dong
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Quanquan Guan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Weiyue Hu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Mingzhi Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yuqing Zhang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Minjian Chen
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Xinru Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Lee J, Lee Y, Kim YS, Choi JG, Go TH, Kim H, Cha YS. Serum ammonia as an early predictor of in-hospital mortality in patients with glufosinate poisoning. Hum Exp Toxicol 2019; 38:1007-1013. [DOI: 10.1177/0960327119855124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background: The mortality rate associated with human glufosinate poisoning is high. We evaluated the usefulness of serum ammonia and sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scores for early prediction of in-hospital mortality in glufosinate ammonium poisoning. Methods: A prospectively collected pesticide poisoning registry at a single academic medical center was retrospectively analyzed. Data were collected from consecutive patients diagnosed with glufosinate ammonium poisoning between May 2007 and February 2018. The initial serum ammonia level was defined as the highest serum ammonia level measured within 12 h after emergency department (ED) arrival. The SOFA and APACHE II scores were calculated using data obtained within the first 12 h after ED arrival. The patients were divided into survivor and nonsurvivor groups by in-hospital death status. Results: In total, 110 patients were included. Ten patients (9.1%) died in the hospital despite treatment. Median initial serum ammonia level was significantly higher in the nonsurvivor group than in the survivor group (219 (range: 158–792) versus 100.5 (range: 25–317) µg/dL, p < 0.001). Median SOFA and APACHE II scores in the survivor and nonsurvivor groups were 2 (range: 0–10) versus 5 (range: 1–8) ( p = 0.044) and 7 (range: 0–28) versus 16 (range: 8–22) ( p = 0.001), respectively. In the multiple logistic regression analysis, the initial serum ammonia level was the only independent predictor (cutoff value: 151 µg/dL). Conclusion: An initial serum ammonia level >151 µg/dL was an independent early predictor of in-hospital mortality in glufosinate ammonium poisoning.
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Affiliation(s)
- J Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Y Lee
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - YS Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - JG Choi
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - TH Go
- Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - H Kim
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - YS Cha
- Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
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