الفهرس 
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Abstract
Analysis of blood gases and acid-base status is an essential tool in assessment of ill patients in the emergency setting. However, the role of acid-base disturbance on survival of acutely poisoned patients has not been thoroughly investigated (Paasma et al., 2012).
The present study was conducted on 100 acutely poisoned patients by toxins with ABG disturbances effect admitted to Ain-Shams Poison Control Center.
It aimed to evaluate the role of (ABG and serum lactate level) for early detection of the severity of toxicity and prediction of death in acutely poisoned patients.
Data recorded included the following:
• Socio-demographic data.
• Clinical data.
• Coma Scaling score
• Investigational data (ABG, serum lactate level).
• Therapeutic interventions
Outcome
After statistical analysis, the results were as follows:
It was found that half of patients fall in the (pediatrics) age group and the other half fall in the (adults) age group,most of poisoned patients are females and from urban areas , the mode of poisoning mostly suicide,and the highest incidence of intoxication occurred among non worker patients.
The present study showed that varieties of toxins were involved as pesticides and hydrocarbons, therapeutic drugs as (CVS drug, CNS drugs and theophylline), and drugs of abuse . In the current study the major of patients poisoned with theophylline , cannabis, organophosphorus and methanol respectly.
Most of the studied patients came with delay time (2) hours, and only few cases was presented with delay time ( 72) hours.
In the present study most of cases have metabolic acidosis, few of them have respiratory alkalosis ,and no patients with metabolic alkalosis .
In present study metabolic acidosis was reported in all of studied patients with acute (anticonvulsant ,and ethanol ) toxicity , half of studied patients with acute (carbamate and AL phosphide ) toxicity , respiratory acidosis was reported in all of studied patients with acute (lithium) toxicity , 40% of studied patients with acute (corrosive) toxicity , respiratory alkalosis was reported in half of studied patients with acute (salicylate ) toxicity , metabolic acidosis with respiratory acidosis reported in all of studied patients with acute (pergaba ) toxicity , metabolic acidosis with respiratory alkalosis was reported in half of studied patients with acute (salicylate ) toxicity , normal ABG was reported in all of studied patients with acute (coingestion of insulin and tegretol ) and (BDZ) , normal ABG with underlying metabolic acidosis compensated with respiratory alkalosis was reported in 46.7% of studied patients with acute (theophylline ) toxicity, 40% of studied patients with acute ( corrosive and clozapex ) toxicity .
In the cuurent study normal lactate level was detected in all of studied patients with acute (lithium , BDZ, clozapex, ethanol, corrosive ,and anticonvulsant) toxicity, mild to moderate elevation of lactate level was detected in all of studied patients with acute (pergaba, and coingestion of insulin and tegretol) toxicity and half of studied patients with acute(carbamate) toxicity , high lactate level was detected in most of studied patients with acute (Co ,and AL phosphide) toxicity , very high lactate level was detected in half of studied patients with acute(zinc phosphide and salicylate) toxicity.
Most of the patients in the study with normal lactate level admitted inpatient, while those with mild to moderate elevation of lactate level 58.3% of them admitted inpatient ,41.7% of them admitted to ICU . For patients with high elevation of lactate level and very high elevation of lactate level most of them admitted to ICU.
47.8% of the dead patients in the study , were with (metabolic acidosis with respiratory acidosis), 30.4% of them, were with (metabolic acidosis .
The current study showed that serum lactate level was a predictor of mortality with excellent diagnostic characteristic ,and the cut off of serum lactate level was ˃ 1.45 .
Conclusion
from the present results, it could be concluded that:
1. Blood gas analysis not only helps in diagnosis,but also in detection of prognosis , and in recognition of patients who need intensive care.
2. The initial lactate level have prognostic utility for detection of fatality from some acute toxicity , and might be used as a biomarker that can aid early decision-making.
3. The highest fatality rate among the acid base disturbances was in metabolic acidosis with respiratory acidosis and then , metabolic acidosis .
4. The cut off point of serum lactate level was ˃ 1.45.
Recommendations
1) the same study recommended to be done as a multicenter with a large number of cases.
2) the same study recommended to be done with evaluation of anion gap.