The effect of the management with fresh frozen plasma on the outcome of patients with acute organophosphate poisoning

Background: Organophosphate (OP) poisoning is an important reason for hospitals and intensive care units admission in the developing countries. OP poisoning patients are classically treated with atropine and oximes, these methods are sometimes shown to be of limited benefit. Objective: Assessment of the effectiveness of the management with fresh frozen plasma (FFP) in improving the outcome of patients with acute OP poisoning. Patient and Methods: A randomized clinical trial study was conducted upon 70 acute OP poisoning patients that were referred to the Emergency Department, Suez Canal University Hospital, Ismailia, Egypt. These patients were randomly divided into two groups (35 each); Control group: Treated with the traditional management protocol of OP (atropine and oximes). FFP group: Treated with the traditional management protocol of OP plus FFP. Results: No significant difference was found in cholinesterase level on admission between both groups, Serum cholinesterase level in the FFP group significantly increased after an hour of FFP infusion (2.48 iu/ml vs. 10.36 iu/ml p<0.0001). There is significant difference between both groups regarding the duration of their hospital stay (2.43 ± 0.5 days for FFP group vs. 3.06 ± 1.4 days for control group; p<0.01) and intensive care unit admission (4 patients in FFP group vs. 12 patients in control group; p<0.04). Conclusion Early management with FFP may be an effective method in the management of acute OP poisoning, as it can improve the clinical outcome through decreasing mortality, duration of hospital stay and the need for ICU admission.