Chi-Wei Lee (Presenter)
Kaohsiung Medical University
Authorship: Chi-Wei Lee (1), Peng-Yu Chen (2), Hung Su (2), Jentaie Shiea (2)
(1) Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (2) Department of Chemistry, National Sun Yat-Sen University, Kaohsiung, Taiwan
| Short Abstract To expedite rescue of intoxicated patients in the emergency department, we developed an analytical method for rapid identification of ingested intoxicants by thermal desorption-electrospray ionization mass spectrometry. Since no pretreatment of the specimen is required, the whole analytical process could be completed within 15 seconds. This technique, together with informational support provided by online mass spectral database, allows for early non-invasive point-of-care identification of ingested intoxicants in the oral fluid or gastric lavage content of intoxicated patients, and is promising in providing important toxicological information for decision-making during critical resuscitation in a timely manner, and hence ensuring the appropriateness of the succeeding management. |
Long Abstract
Self-poisoning with pesticides accounts for approximately one-third of all suicides worldwide. To expedite rescue in the emergency department, we developed an analytical method for rapid identification of ingested pesticides by means of thermal desorption-electrospray ionization mass spectrometry (TD-ESI/MS). As the whole analytical process is extremely short, this technique allows for early non-invasive point-of-care identification of pesticides in the oral fluid or gastric lavage content of self-poisoning patients in the emergency room, providing important toxicological information for decision-making during critical resuscitation.
Mis-swallowing of oral medications is not uncommon in the pediatric group. Acute poisoning should be handled with high efficiency in order to minimize morbidity and mortality in the emergency room. History-taking and physical examination are not always reliable. In our collaborative study, we developed a rapid point-of-care ambient mass spectrometric method for early identification of ingested oral medications in gastric lavage content. A direct metallic sampling probe was dipped into this mixture of gastric juice and medications. Since no pretreatment of the specimen was required, the sampling step, followed by thermal desorption-electrospray ionization and mass spectrometric analysis of the medications were completed within 15 seconds. This technique, with informational support provided by online mass spectral database, allows for early point-of-care identification of oral medications in the gastric contents obtained during lavage of mis-swallowing children in the emergency room, and is promising in providing important toxicological information to ensure appropriateness of the succeeding medical management.
References & Acknowledgements:
1. M. Shannon. Ingestion of Toxic Substances by Children. N Engl J Med. 2000, 342, 186.
2. J. Shiea, M. Z. Huang, H. J. Hsu, C. Y. Lee, C. H. Yuan, I. Beech, J. Sunner. Electrospray-assisted laser desorption/ionization mass spectrometry for direct ambient analysis of solids. Rapid Commun. Mass Spectrom. 2005, 19, 3701.
3. D. Gunnell, M. Eddleston, M. R. Phillips, F. Konradsen. The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 2007, 7, 357.
4. Peter JV, Jerobin J, Nair A, Bennett A. Is there a relationship between the WHO hazard classification of organophosphate pesticide and outcomes in suicidal human poisoning with commercial organophosphate formulations? Regul Toxicol Pharmacol 2010;57:99-102.
5. M. Z. Huang, C. C. Zhou, D. L. Liu, S. S. Jhang, S. C. Cheng, J. Shiea. Rapid characterization of chemical compounds in liquid and solid states using thermal desorption electrospray ionization mass spectrometry. Anal. Chem. 2013, 85, 8956.
6. Chowdhary S, Bhattacharyya R, Banerjee D. Acute organophosphorus poisoning. Clin Chim Acta 2014;431:66-76.
7. C. Shiea, Y. L. Huang, D. L. Liu, C. C. Chou, J. H. Chou, P. Y. Chen, J. Shiea, M. Z. Huang. Rapid screening of residual pesticides on fruits and vegetables using thermal desorption electrospray ionization mass spectrometry. Rapid Commun. Mass Spectrom. 2015, 29, 163-170.
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