Regarding 'repeated pulse intramuscular injection of pralidoxime chloride in severe acute organophosphorus pesticide poisoning'

摘要

We read with interest the recent article on the use of pralidoxime in acute organophosphorus (OP)–poisoned patients (AOPP) [1]. Clarification of several issues would greatly assist in our ability to determine whether the results presented are valid and broadly applicable. Although not clearly stated, it seems that this retrospective study was a comparison of protocols from 2 intensive care units (ICUs) that care for AOPP. Therefore, it is unclear whether the treated populations are comparable, which makes interpretation of the results challenging. The treatment protocol used for one group of patients is detailed with regard to pralidoxime and atropine dosing, whereas the other is vague and uncertain. Interestingly, the cumulative atropine dose was evaluated as an end point when atropine, not pralidoxime, is regarded as the cornerstone of AOPP.