ReviewLancet (London, England)2008
Management of acute organophosphorus pesticide poisoning.
Review in Lancet (London, England), 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 338 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Study Effect of WHO Recommended Dose of Pralidoxime in the Treatment of Organophosphorus Poisoning
Effect of Adding Nebulized Salbutamol to Intravenous Atropine and Oxygen During Resuscitation of OP Pesticide Poisoned Patients
Who cites it
338 citing papers in PubMed, 3 syntheses or guidelines pooled it, 1,132 citations in OpenAlex.
- Systematic Review and Meta-Analysis of Lipid Emulsion for Non-Local Anesthetic Poisoning.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2026Pooled it
- Therapeutic Interventions in Organophosphate Poisoning: An Umbrella Review of Systematic Reviews.The western journal of emergency medicine · 2026Pooled it
- Toxicity testing of pesticides in zebrafish-a systematic review on chemicals and associated toxicological endpoints.Environmental science and pollution research international · 2020Pooled it
- Pain in the acephate: A case of protracted toxicity after an intentional ingestion of ant killer.Toxicology reports · 2026Article
- Delayed Myoclonus and Bilateral Globus Pallidus Lesions Following Organophosphate Poisoning: A Case Report.The American journal of case reports · 2026Article
- Toxidromes.Nature reviews. Disease primers · 2026Review
- Multifunctional Conductive Polymer Nanocomposite for Intelligent Pesticide Sensing: Trends, Challenges, and Future Prospects.Molecules (Basel, Switzerland) · 2026Review
- Detoxifying Effects of a Phenolic-RichInternational journal of molecular sciences · 2026Article
- A Sustainable Treatment Protocol for Organophosphate Poisoning in Rural Kenya for Facilities without Intensive Care Units and Where Transfer Is Not Possible.The American journal of tropical medicine and hygiene · 2026Article
- Surgical Treatment for Hemorrhagic Infarction of Small Intestine Caused by Organophosphate Poisoning.Clinical case reports · 2026Article
- Article
- From Cholinergic Crisis to Anticholinergic Delirium: When the Antidote Mimics the Poison.Cureus · 2026Article
- Association of respiratory health with occupational exposures in the Burden of Obstructive Lung Disease (BOLD) cohort: a multinational longitudinal study.BMJ open respiratory research · 2026Observational
- SynergisticiScience · 2026Article
- Development of a double-pharmacophore workflow for screening subtype-selective MMolecular diversity · 2026Article
- Next-generation broad-spectrum reactivators for effective countermeasure against organophosphorus poisoning.Archives of toxicology · 2026Article
- Article
- Characteristics and prognostic factors of adult poisoning patients in the intensive care unit: A retrospective cohort study using the Japanese intensive care patient database.Toxicology reports · 2026Article
- Current review on inducible nitric oxide synthase and Src tyrosine kinase inhibitors as disease-modifiers in preclinical models of epilepsy.Histology and histopathology · 2026Review
- Predictors of intermediate syndrome after organophosphorus poisoning and its management in Nepal.Acute and critical care · 2026Article
278 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 4 countries.
Funding
Abstract
Organophosphorus pesticide self-poisoning is an important clinical problem in rural regions of the developing world, and kills an estimated 200,000 people every year. Unintentional poisoning kills far fewer people but is a problem in places where highly toxic organophosphorus pesticides are available. Medical management is difficult, with case fatality generally more than 15%. We describe the limited evidence that can guide therapy and the factors that should be considered when designing further clinical studies. 50 years after first use, we still do not know how the core treatments--atropine, oximes, and diazepam--should best be given. Important constraints in the collection of useful data have included the late recognition of great variability in activity and action of the individual pesticides, and the care needed cholinesterase assays for results to be comparable between studies. However, consensus suggests that early resuscitation with atropine, oxygen, respiratory support, and fluids is needed to improve oxygen delivery to tissues. The role of oximes is not completely clear; they might benefit only patients poisoned by specific pesticides or patients with moderate poisoning. Small studies suggest benefit from new treatments such as magnesium sulphate, but much larger trials are needed. Gastric lavage could have a role but should only be undertaken once the patient is stable. Randomised controlled trials are underway in rural Asia to assess the effectiveness of these therapies. However, some organophosphorus pesticides might prove very difficult to treat with current therapies, such that bans on particular pesticides could be the only method to substantially reduce the case fatality after poisoning. Improved medical management of organophosphorus poisoning should result in a reduction in worldwide deaths from suicide.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.