الفهرس 
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Abstract
Acute poisoning is one of the most important health issues both in developing and developed countries, and accounts for a significant proportion of ICU admissions.
In Egypt, acute poisoning is becoming a major challenge due to insufficient rules and regulations concerning pharmaceutical drugs and chemicals, poor monitoring system, as well as easy accessibility to a variety of pharmaceutical drugs and agrochemicals.
The present study aimed to throw light on the pattern and outcome of patients with acute poisoning admitted to the Critical Care Department of Alexandria Main University Hospital over a period of six months from 1st July to 31st December 2016.
The study included 54 patients admitted to ICU with acute poisoning representing 11% of all ICU admissions during the same study period. Data was collected in a specially designed sheet (Appendix I) including; demographic data, date and time of admission, circumstances (suicidal, accidental, overdose in addict), type of taken poison, time lapsed till seeking medical care, clinical manifestations, investigations and treatment received. Duration of ICU stay and outcome were also documented.
This study revealed the following results:
Demographic data
The age of patients ranged from 1.5 years old up to 62 years old with a mean of 26.58 ± 14.2 years. Most of patients were in the age group (10-29 years). Males outnumbered females in all age groups with male to female ratio of 1.08:1.
More than half of patients (55.6%) were from urban areas while 44.4% belonged to rural ones.
The highest percentage of patients was unemployed (37%), followed by manual workers (25.9%). Pre-school children (9.3%) were patients aged <10 years.
Data related to poisoning:
The majority of cases were suicidal poisoning (63%), followed by accidental poisoning (25.9%) then overdose in addicts (11.1%).
In the accidental poisoning, 78.6% of patients were males and 21.4% were females. However, in the suicidal poisoning, females showed a higher percentage (67.6%) compared to males (32.4%).
In the suicidal poisoning, the highest percentage (79.4%) was found in the age group 10-29 years.
Pesticides (organophosphorus insecticides, aluminum phosphide and zinc phosphide) were the poisoning agents in the highest percentage of patients (42.6%) followed by medications (psychotropic drugs, digoxin, calcium channel blockers and theophylline) (31.5%).
Suicidal attempts with pesticides and medications were more recorded among young females while accidental poisoning was more common among males.
Patients aged 10-29 years represented the highest percentage of patients poisoned by pesticides and medications.
Pesticide poisoning was highly recorded among patients from rural areas. On the other hand; medications were the most common poisons among patients from urban areas.
Pesticides were the most common poisoning agent among students and housewives (66.7% and 60% respectively). Half of the unemployed patients were admitted with medication poisoning. Among the pre-school children (<10 years), corrosives and medications were the most commonly encountered poisons.
Time lapsed till seeking medical care was within 6 hours after poisoning in the majority of patients (81.4%) while ten patients (18.5%) came late to hospital (>6 hours) after poisoning.
Treatment:
Ventilatory support and antidotes followed by restoring acid-base and electrolyte balance then use of vasoactive agents were the most frequent types of treatment used in the ICU.
Development of complications in ICU:
Cardiogenic shock and aspiration pneumonitis were highly recorded in cases of pesticides poisoning while life-threatening arrhythmias were more common in cases of drug poisoning.
Length of stay (LOS) in ICU and outcome:
The majority of cases stayed in ICU for 3-7 days. Ten patients died with a mortality rate of 18.5%.
Pesticides were the most common poisoning agents causing death (80%).
Outcome was significantly related with time lapsed till seeking medical care and also with development of complications in ICU.