Fresh Red Blood Transfusion as a Successful Erythrocyte Cholinesterase Supplement in Organophosphate Poisoning

Despite improvements to standard treatments (atropine, oxime) and intensive care management, the mortality associated with organophosphate (OP) poisoning has not substantially decreased. In this study, we evaluated the role of packed red blood cells (RBCs) transfusion in acute OP poisoning. Patients diagnosed with OP poisoning were included in this prospective study, and then were transfused with packed RBCs stored less than 10 days or 10 to 35 days. Cholinesterase (ChE) level in blood, atropine usage and durations were recorded. We found both shorterand longer-storage RBCs (200~400 ml) significantly increased AChE level in blood, improved ChE recovery, and reduced the usage and shortened the duration of atropine and followed clinical recovery. Shorter-storage RBCs had better effect than longer-storage (longer storage) ones. Due to erythrocyte cholinesterase supplement, packed RBCs might be used as an alternative approach in patients with OP poisoning, especially at the early stages.