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HOME > J Korean Soc Clin Toxicol > Volume 12(2); 2014 > Article
The Clinical Features and Prognostic Factors in Adults with Acute Etrodotoxin Poisoning Caused by Ingesting Puffer Fish
Yong Soo Jo, Byeong Jo Chun, Jeong Mi Moon, Hyun Ho Ryu, Yong Hun Jung, Sung Min Lee, Kyung Hwan Song, Jin Ho Ryu
Journal of The Korean Society of Clinical Toxicology 2014;12(2):46-53
DOI: https://doi.org/
Published online: December 31, 2014
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1Department of Emergency Medicine, Medical School, Chonnam National University
2Department of Emergency Medicine, Medical School, Chonnam National University
3Department of Emergency Medicine, Medical School, Chonnam National University
4Department of Emergency Medicine, Medical School, Chonnam National University
5Department of Emergency Medicine, Medical School, Chonnam National University
6Department of Emergency Medicine, Medical School, Chonnam National University
7Department of Emergency Medicine, Medical School, Chonnam National University
8Department of Emergency Medicine, Mokpo Jung-ang Hospital

Purpose: We conducted this study in order to determine clinical features and prognostic factors in adults with acute tetrodotoxin (TTX) poisoning caused by ingestion of puffer fish. Methods: In this retrospective study, 107 patients were diagnosed with TTX poisoning. The subjects were divided into two groups according to duration of treatment; Group I, patients were discharged within 48 hours (n=76, 71.0%), Group II patients were discharged after more than 48 hours (n=31, 29.0%). Group II was subsequently divided into two subgroups [IIa (n=12, 11.2%), IIb (n=19, 17.8%)] according to the need for mechanical ventilation support. Results: In multivariable logistic regression analysis, the predictors of the need for treatment over 48 hours were dizziness (odds ratio [OR], 4.72; 95% confidence intervals [CI], 1.59-12.83), time interval between onset of symptom and ingestion (OR, 0.56; 95% CI, 0.16-0.97), $PaCO_2$<35 mmHg (OR, 8.37; 95% CI, 2.37-23.59). In addition, predictors of the need for mechanical ventilation were a time interval between onset of symptoms and ingestion (OR, 0.54; 95% CI, 0.11-0.96) and $PaCO_2$<35 mmHg (OR, 5.65; 95% CI, 1.96-18.66). Conclusion: Overall, dizziness, time interval between onset of symptoms and ingestion, ${Delta}DBP$ and $PaCO_2$<35 mmHg predict the need for treatment over 48 hours, time interval between onset of symptoms and ingestion and $PaCO_2$<35 mmHg predict the need for mechanical ventilation support after acute TTX poisoning.

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JKSCT : Journal of The Korean Society of Clinical Toxicology