Quantification of Organophosphorus Insecticide Removed by Gastric Lavage in Acutely Poisoned Patients: An Observational Study

Asisha Janeela Mathansingh, Arun Jose, Jude Joseph Fleming, Kundavaram Paul Prabhakar Abhilash, Vignesh Kumar Chandiraseharan, Audrin Lenin, Samuel George Hansdak, Ramya Iyyadurai, Thenmozhi Mani, John Victor Peter, Michael Eddleston, Anand Zachariah

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: The effectiveness of gastric lavage in organophosphorus poisoning has not been established. We assessed the ability of gastric lavage to remove organophosphorus insecticides as a preliminary stage in assessing effectiveness.

Methods: Organophosphorus poisoning patients presenting within
Results: 42 patients underwent gastric lavage. 8 (19.0%) patients were excluded because of lack of analytical standard for ingested compounds. Insecticides were detectable in the lavage samples of 24/34 (70.6%) patients. Lipophilic organophosphorus compounds were detected in 23/24 patients while no hydrophilic organophosphorus compounds could be detected in six patients with reported ingestion of hydrophilic compounds. For chlorpyrifos poisoning (n=10), only 0.65 (S.D 1.2) mg of estimated ingested amount (n=5) of 8,600 (S.D 3,200) mg was recovered by gastric lavage. The mean proportion of compound removed by initial gastric aspirate was 79.4%and subsequent 3 cycles removed 11.5%, 6.6% and 2.7%.

Conclusion: Lipophilic organophosphorus insecticides could be quantified in stomach contents of organophosphorus poisoning patients with the first aspiration or lavage being most effective. The amount removed was very low hence, routine use of gastric lavage for organophosphourus poisoning patients arriving within 6 hours is unlikely to be beneficial.
Original languageEnglish
Pages (from-to)397-402
JournalIndian Journal of Critical Care Medicine
Issue number6
Early online date31 May 2023
Publication statusE-pub ahead of print - 31 May 2023

Keywords / Materials (for Non-textual outputs)

  • Organophosphorus
  • insecticide poisoning
  • gastric lavage
  • efficacy


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