Meenakshi Hospital Thanjavur, the first hospital to have a multidisciplinary critical care department in the delta region of Tamil Nadu, has saved the life of a 14-year old girl who consumed an extremely lethal rodenticide (“Ratol paste containing yellow phosphrous”), by performing plasmapheresis, an advanced blood treatment that removes toxins circulating in the bloodstream.
The girl was under depression and consumed ratol paste that contained 5% yellow phosphorus, a toxic component, which is considered highly lethal. Yellow phosphorus is a highly protein-binding substance like cyanide. Since eliminating it from the human body is a big challenge, rodenticide poisoning has a high mortality rate in rural areas.
Conventionally, in poisoning cases, some form of dialysis (haemodialysis or hemoperfusion) is used to purify the blood. However, Meenakshi Hospital utilized plasmapheresis, which unlike hemodialysis or hemoperfusion, does not produce complications such as low blood pressure or heart rate. Plasmapheresis, also known as plasma exchange, which is more effective for this rodenticide poison. It involves using a special machine to separate the affected plasma, the liquid part of the blood, from the blood cells, and replace it with good plasma or a plasma substitute. The process is similar to kidney dialysis.
Commenting about the patient, Dr. T. Senthil Kumar, Head, Critical Care Medicine and Toxicology Unit, Meenakshi Hospital said that the patient consumed the rodenticide due to her personal problem and depression. The girl was admitted to the hospital when she developed complaints of vomiting, diarrhea, and headache four days after ingestion. We identified jaundice and renal issues during diagnosis. Since the rodenticide she consumed contained about 5% yellow phosphorus, a highly protein-binding toxin, we immediately utilized plasmapheresis. After undergoing three cycles of this blood treatment, her condition improved, and the jaundice gradually subsided. We also treated other complications. Following the treatment, she stayed in the hospital, mainly for psychological rehabilitation, and was discharged as a healthy child.
On the advances in critical care services Dr. Senthil Kumar said, “We treat and provide holistic care for poisoning cases. Among the most common poisons are insecticides (organophosphate) and rodenticides (yellow phosphorus). Even today, yellow phosphorus accounts for the highest mortality. But as people generally think it is not treatable. Through our multidisciplinary approach and procedures like plasmapheresis, we have significantly reduced the mortality rate of rodenticide poisoning in recent years. However, it's crucial to have round the clock multidisciplinary critical care team, including psychiatrists and psychologists providing meticulous care to ensure long-term relief for patients.”
Meenakshi Hospital’s Critical Care Medicine and Toxicology Unit is led by qualified critical care physicians, who are supported by consultants from all specialties and super specialties across various departments. The unit offers 24x7 comprehensive care not only for toxicology patients, but also for critically ill patients in specialties such as coronary/cardiology, neurology, nephrology, obstetrics, as well as post-surgical and surgical critical care, and trauma care patients. With all latest technologies and advanced equipment’s to provide monitor the improvement of the patients health every minute.