Effect of Intravenous Lipid Emulsion Therapy on Serum Pseudocholinesterase in Experimental Model of Diazinon Intoxication

Öz

Diazinon ile oluşturulan intoksikasyon modelinde İntravenöz lipit emülsiyon tedavisinin (% 20 lipid solüsyonu) serum pseudokolinesteraz düzeyi üzerine etkisinin araştırılması amaçlandı. Organofosfat zehirlenmeleri acil servise başvuran hastalar arasında önemli bir yer tutmaktadır. En sık kullanılan organik fosforlu bileşikler diazinon, malation, paration'dur. İntravenöz lipit emülsiyon (ILE) tedavisi lokal anesteziklerin yol açtığı sistemik toksisite durumlarında yeni bir tedavi yöntemi olarak kullanılmaktadır. 21 adet Wistar-albino grubu sıçan yedişerli üç eşit gruba ayrıldı. Grup I, kontrol; Grup II, diazinon; Grup III, diazinon + İntravenöz lipit emülsiyon tedavisi grubu olarak düzenlendi. Grup I’e sadece 1 ml mısır yağı gavaj yolu ile verildi. Grup II’ye 335 mg/kg diazinon (gavaj yolu ile) verildi. Grup III’ e diazinon’a ilave olarak kuyruk veninden 3 ml/kg olacak şekilde %20 lipit solüsyonu verildi. Deney sonunda hayvanlardan alınan kanlarda serum psödokolinesteraz düzeyleri bakıldı. Psödokolinesteraz düzeyleri analiz edildiğinde diazinon ile diazinon+lipit grubu arasında istatistiksel açıdan önemli bir fark bulunamadı. Bununla birlikte kontrol grubu ile diğer gruplar arasında önemli farklılık tespit edildi (p < 0.05). Çalışmamızda lipit tedavisinin serum pseudokolinesreraz üzerine olumlu etkisi tespit edilemedi. Daha düşük dozlardaki toksikasyon modelinde yeni çalışmalar denenebilir

Anahtar Kelimeler

• Diazinon, psödokolinesteraz, lipid

Effect of Intravenous Lipid Emulsion Therapy on Serum Pseudocholinesterase in Experimental Model of Diazinon Intoxication

Öz

The aim of this study was to investigate the effect of intravenous lipid emulsion (20% lipid solution) on serum pseudocholinesterase in an toxication model of diazinon. Organophosphate poisoning has a different importance for individuals those admitted to the emergency service due to poisoning. The most commonly used organic phosphorus compounds are diazinon, malathion, and parathion. Intravenous lipid emulsion (ILE) treatment is used as a new treatment method in systemic toxicity cases caused by local anesthetics. Twenty-one male Wistar albino rats, (weighing 180&ndash;200 g) were randomly divided into three equal groups. Group I was control, while Group II was diazinon and Group III was diazinon + lipid emulsion treatment. Only 1 ml corn oil was given by gavage to the rats in Group I. A diazinon dose of 335 mg/kg was given by gavage to the rats in Group II. In addition to diazinon, a 20% lipid solution (3 ml/kg) was administered via tail vein to the rats in Group III. At the end of the experimental period, blood samples were taken from animals, and serum pseudocholinesterase levels were measured. When the pseudocholinesterase levels were analyzed, no significant difference was found between diazinon and diazinon + lipid emulsion treatment groups. However, a significant difference was found between control and the others (p < 0.05). In our study, there was no positive effect of lipid treatment detected on serum pseudocholinesterase. Toxication models with lower doses can be designed in future studies.

Anahtar Kelimeler

• Diazinon, pseudocholinesterase, lipid

Kaynakça

1. Eddleston M, Phillips MR. BMJ. Self poisoning with pesti- cides 2004; 3;328(7430):42-4.
2. Liu SH, Lin JL, Weng CH, Yet al. Heart Rate-Corrected QT Interval Helps Predict Mortality after Intentional Organophosphate Poisoning. PLoS One 2012; 7(5):36576.
3. Sarıtas A, Cakır Z, Aslan S. Organophosphate and Carbamate Toxicity. EAJM 2007;39, : 55-9
4. Kamanyire R, Karalliedde L. Organophosphate toxicity and occupational exposure. Occup Med (Lond) 2004;54:69-75.
5. Antonijevic B, Stojiljkovic MP. Unequal efficacy of pyri- dinium oximes in acute organophosphate poisoning. Clin Med Res 2007;5:71-82.
6. Rothschild L, Bern S, Oswald S, Weinberg G. Intravenous lipid emulsion in clinical toxicology. Scand J Trauma Resusc Emerg Med 2010;18:51. Review.
7. Harvey M, Cave G, Prince G, Lahner D. Epinephrine in- jection in lipid-based resuscitation from bupivacaine- induced cardiac arrest: transient circulatory return in rabbits. Anesth Analg 2010;111:791-6.
8. Foxall G, McCahon R, Lamb J, Hardman JG, Bedforth NM. Levobupivacaine-induced seizures and cardiovascular col- lapse treated with Intralipid. Anaesthesia 2007; 62:516-8.

9. Zhou Y, Zhan C, Li Y, Zhong Q, Pan H, Yang G. Intravenous lipid emulsions combine extracorporeal blood purifica- tion: a novel therapeutic strategy for severe organophos- phate poisoning. Med Hypotheses 2010;74: 309-11.
10. Kayıpmaz A.E, Gülalp B, Benli S. 2011. Current Aspects in Lipophilic Drug Toxicity. JAEM 2011; doi: 10.5152/ jaem.2011.019 (In Turkish).
11. Ludot H, Tharin JY, Belouadah M, Mazoit JX, Malinovsky JM. Successful resuscitation after ropivacaine and li- docaine-induced ventricular arrhythmia following pos- terior lumbar plexus block in a child. Anesth Analg 2008;106:1572-4.
12. Weinberg GL, Ripper R, Murphy P, Edelman LB, Hoffman W, Strichartz G, Feinstein DL Lipid infusion accelerates removal of bupivacaine and recovery from bupivacaine toxicity in the isolated rat heart. Reg Anesth Pain Med 2006;31:296-303.
13. Finn SD, Uncles DR, Willers J, Sable N. Early treatment of a quetiapine and sertraline overdose with Intralipid. Anaesthesia 2009;64:191-4.
14. Harvey M, Cave G. Intralipid outperforms sodium bicar- bonate in a rabbit model of clomipramine toxicity. Ann Emerg Med 2007;49:178-85.
15. Tebbutt S, Harvey M, Nicholson T, Cave G. Intralipid pro- longs survival in a rat model of verapamil toxicity. Acad Emerg Med 2006;13:134-9.
16. Harvey MG, Cave GR. Intralipid infusion ameliorates pro- pranolol induced hypotension in rabbits. J Med Toxicol 2008;4:71-6.