Arterial Blood Lactate Level as a Biomarker of Risk among Antipsychotics Poisoned patients

Aim: Antipsychotics (APs) are commonly used in suicidal attempts among their users or their relatives. This study had investigated early arterial blood lactate levels as a biomarker for severity and outcome in APs poisoned patients. Methods: Male patients attended to Toxicology unit of Mansoura Emergency Hospital was involved in this study during the period from September, 2013 to January 2015. The Clinical data were collected in addition to the serum levels of the ingested APs. Arterial radial blood lactate levels were assessed on admission and later on after 48 hrs. Results: Thirty cases were studied. Cases were intoxicated with chlorpromazine (CPZ), Risperidone (RIS), haloperidol (HAL) or olanzapine (OLZ). Most cases were manifested by tachycardia and disturbed conscious level. Lactate levels were found to be correlated with the ingested APs drugs serum levels (P=0.0028, <0.0001, <0.0001 and 0.0073 for CPZ, HAL, OLZ and RIS respectively; Spearman rank correlation). Furthermore, Lactate levels were inversely correlated with systolic blood pressure, Diastolic blood pressure and Glasgow coma scale (P<0.0001 for each clinical parameter; Spearman rank correlation). However, lactate levels were directly correlated with the pulse of the studied cases (P=0.0007; Spearman rank correlation). In addition, there was statistically significant difference in arterial lactate levels between discharged, wards and intensive care unit admitted cases (P<0.0001; ANOVA). Conclusion: Arterial lactate levels can be used as a biomarker with important prognostic value in APs poisoned patients' risk assessment.