Acute Respiratory Distress Syndrome in Drug and Chemical Poisoning: A Cross-sectional Study

Background: Poisonings are a major medical emergency, contributing to ۱۵-۲۰% of hospital visits. Acute respiratory distress syndrome (ARDS), defined by acute hypoxemia and non-cardiogenic pulmonary edema, presents significant challenges in diagnosis and management.  Objectives: This study investigates the incidence of ARDS in patients with drug and chemical poisoning hospitalized at Shah Vali Hospital in Yazd City, and Shahid Beheshti Hospital in Taft City, Iran from ۲۰۱۴ to ۲۰۲۳. Methods: We conducted a descriptive cross-sectional study involving patients with drug and chemical poisoning presenting to the emergency departments of the two hospitals. After obtaining ethical approval, we reviewed medical records of eligible patients. Data were analyzed using SPSS software, version ۲۵, presenting qualitative data as frequencies and percentages, and quantitative data as Mean±SD. The chi-square test assessed statistical significance, with P<۰.۰۵ deemed significant. Results: Our analysis included ۶۱ patients, comprising ۷۷% men and ۲۳% women, with a mean age of ۴۶.۱ years and an average hospitalization duration of ۹.۷ days. The primary cause of poisoning was suicide, accounting for ۴۹.۲% of cases, predominantly through oral ingestion (۹۶.۷%). Methadone was identified as the most common poisoning agent. Notably, ۶۸.۹% of patients had a history of addiction, and ۲۷.۹% required dialysis, while sepsis was present in ۳۱.۱% of cases. Among patients with ARDS, ۲۱.۳% had pre-existing pulmonary conditions. Elevated urea and creatinine levels were observed in ۸۵.۲% of cases, and metabolic acidosis was noted in all patients. Seizures occurred in ۳۲.۸% of individuals, with an overall mortality rate of ۵۹%. Although no significant differences in mortality were associated with addiction history (P=۰.۳۱۰), a strong correlation was found with the type of poisoning agents (P<۰.۰۰۱). Conclusion: The study found ۵۹% mortality rate among ARDS patients due to drug and chemical poisoning, emphasizing the need for effective management strategies. A significant proportion of cases were involved with addiction, primarily to methadone, yet no mortality correlation with addiction was observed. The findings underscore the complexities of treating ARDS in the context of poisoning, necessitating a diverse approach to improve patient outcomes.

کلیدواژه ها:

Acute respiratory distress syndrome (ARDS) ، Drug poisoning ، Chemical poisoning