Razi Journal of Medical Sciences

Background: “Shock” is one of the most important and frequently life threatening complications of chemical and drug toxicities. The aim of this study was to explore occurrences of shock induced by poisoning and their relation to toxic agents and outcome of patients in Baharloo Hospital, Tehran.

Methods: in a cross-sectional study from June 2011 to June 2012 patients admitted as poisoning were assessed at Baharloo Hospital. Some 196 patients who had a systolic blood pressure less than 80 mmHg despite infusion of 2-3 liter of normal saline within 30 minutes were included in this study. Of these, 112 (57.1%) were male and 84 (42.9%) female. Collected data was analyzed using SPSS v. 19. 

Results: The poisioning induced shock complication was more frequently occurred within 21-40 years range of age that included 57.1% of the patients. Aluminum phosphide poisoning was the most frequent cause of shock as well as death, with a frequency rate of 37.7% and 82.4% respectively. Totally and despite intensive care, 80 patients (40.8%) died in which 64 cases (32.6%) was because of refractory shock. In fact, all deaths in the context of tricyclic anti-depressants, calcium channel blockers and α2 agonists as well as 90.2% of deaths in aluminum phosphide poisoning, were related to refractory shock. 

Conclusion: This study showed that the poisoning induced shock was related with poor prognosis. As there are specific treatment strategies for combat shock in particular toxicities, it is necessary for doctors to learn more about them, and in the case of such situations effectively control the complication.