Retrospective analysis of intoxicated patients in our intensive care unit

Objective: Intoxications occurs generally accidentally, due to suicide attempts or related to drug abuse. We aimed to analyze intoxicated patients admitted to our intensive care unit (ICU) during three years period.
Materials and methods: Between 2007 and 2009, 66 ICU patients treated due to intoxication were retrospectively analyzed considering demographic variables, active ingredient associated with intoxication, hospital stay and ventilation time.
Results: There were 43 women and 23 men. The mean age of cases was 24,92±10,26 years and 11 of them were ≤14 years old. The mean hospitalization time of cases was 2,48±0,76 days. The mechanical ventilation was applied to 8 of cases with a mean mechanical ventilation time of 2,28±1,58 days. One of the cases died on the 3rd day of hospitalization and other 65 cases were uneventfully discharged. Hemodiafiltration was applied in two cases intoxicated due of whom one was intoxicated by fungi and the other was intoxicated with methyl alcohol. Intoxication cases were 15% all subjects treated in ICU during three years period. In 45% of patients, an antidepressant medication was found to be associated with suicide attempts and amitriptyline (63%) was the most commonly used.
Conclusion: Good prognosis and the low mortality rate were supposed to be related to young age and healthy condition of the patients in addition to low dosage of the medicine-below the toxic level- being conscious and adequate respiratory functions at fist admission. We concluded that both marketing control necessity of control over, sales of amitriptyline, which is presently available without prescription and in the major intoxication group, is as important as treatment on time.

Yoðun bakým ünitemizdeki intoksikasyon olgularýnýn geriye dönük incelenmesi

Amaç: Ýntoksikasyonlar intihar amacýyla, kazayla ya da madde baðýmlýlýðý gibi sebeplerle karþýmýza çýkmaktadýr. Bu çalýþmada yoðun bakým ünitemizde üç yýl süresince takip ve tedavi edilen inoksikasyon olgularýný incelemeyi amaçladýk.
Gereç ve Yöntem: 2007- 2009 tarihleri arasýnda yoðun bakým ünitemizde intoksikasyon nedeniyle takip edilen 66 olgunun geriye dönük demografik verileri, etken maddeler, yatýþ süreleri ve mekanik ventilasyon ihtiyaçlarý incelendi.
Bulgular: Olgularýn 43’ü kadýn, 23’ü erkek idi. Yaþ ortalamasý 24,92±10,26 olup 11 tanesi 14 yaþ ve altýndaydý. Ortalama yatýþ süreleri 2,48±0,76 gündü. Sekiz olguya ortalama 2,28±1,58 gün yapay solunum uygulanmýþtýr. Olgulardan bir tanesi yatýþýnýn üçüncü gününde kaybedilirken, 65 olgu þifayla taburcu edilmiþtir. Mantar ve metil alkol intoksikasyonu olan 2 olguya hemodiyafiltrasyon uygulanmýþtýr. Ýntoksikasyonlar 3 yýl içinde yoðun bakým ünitemizde yatan hastalarýn %15’ini oluþturmaktadýr. Ýntihar amacýyla %45 oranýnda antidepresan kullanýlmýþ ve antidepresan olarak en sýk (%63) amitriptilin
seçilmiþtir.
Sonuç: Olgularýn büyük kýsmýnýn genç ve saðlýklý olmasý, toksik doza ulaþmayan ilaç alýmý, þuurlarýnýn açýk, solunumlarýnýn yeterli olmasý prognozun iyi, mortalitenin düþük olmasýna sebep olmaktadýr. Zamanýnda yapýlan doðru müdahale kadar reçetesiz ulaþýlabilen ve en büyük intoksikasyon grubunu oluþturan amitriptilinin de satýþýnýn kontrolünün gerektiði düþüncesindeyiz.