Substitution of Exogenous Cholinesterases in the Treatment of Severe Organophosphate Poisoning

The document discusses the treatment of severe organophosphate poisoning, which is more common in Asia and East Africa due to agricultural use and accounts for about 30% of suicide cases. Organophosphates can also be used as chemical warfare agents, with notable incidents in Iraq, Tokyo, and the UK. Despite available treatments, these poisonings have high mortality rates. The study describes a successful trial combining standard treatment with atropine/oxime and exogenous cholinesterases administered via blood transfusion. This approach showed positive effects in patients with reduced endogenous cholinesterase activity (down to 20%), potentially avoiding the need for mechanical ventilation and preventing fatal complications.