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VOLUME 28 , ISSUE 1 ( January, 2024 ) > List of Articles


Clinical Profile and Predictors of Intensive Care Admission in Neonicotinoid Poisoning in a Tertiary Care Hospital in South India

Lalhming Sanga, Amita Jacob, Jonathan Arul Jeevan Jayakaran, Ramya Iyadurai

Keywords : Intensive care, Neonicotinoid, Outcomes, Pesticide poisoning

Citation Information : Sanga L, Jacob A, Jayakaran JA, Iyadurai R. Clinical Profile and Predictors of Intensive Care Admission in Neonicotinoid Poisoning in a Tertiary Care Hospital in South India. Indian J Crit Care Med 2024; 28 (1):66-69.

DOI: 10.5005/jp-journals-10071-24599

License: CC BY-NC 4.0

Published Online: 30-12-2023

Copyright Statement:  Copyright © 2024; The Author(s).


Background and objectives: Neonicotinoids are a newer class of pesticides that are believed to cause predominantly mild toxicity in humans. This study aimed to describe the clinical features of neonicotinoid poisoning and identify predictors of severe toxicity. Materials and methods: This retrospective study included all patients with neonicotinoid poisoning admitted to a Tertiary Care Center in India over an 18-year period. Clinical and laboratory features were compared against outcomes to identify predictors of the need for intensive care admission. Results: Twenty-eight patients were included in the study of which 28.6% had severe disease requiring ICU admission. A higher respiratory rate, blood lactate level, SOFA, and qSOFA scores as well as a lower Glasgow coma score at presentation predicted ICU admission. First-generation compounds and imidacloprid consumption were associated with longer ICU stays and a longer duration of invasive ventilation. Conclusion: Neonicotinoid compounds can cause significant toxicity with oral ingestion. Imidacloprid and other first-generation compounds were associated with more severe toxicity requiring intensive care. Simple clinical parameters assessed at presentation can be used to predict severe disease and the need for ICU care. Larger, prospective studies are required to confirm these findings.

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  1. Phua DH, Lin CC, Wu ML, Deng JF, Yang CC. Neonicotinoid insecticides: An emerging cause of acute pesticide poisoning. Clin Toxicol (Phila) 2009;47(4):336–341. DOI: 10.1080/15563650802644533.
  2. Lin PC, Lin HJ, Liao YY, Guo HR, Chen KT. Acute poisoning with neonicotinoid insecticides: A case report and literature review. Basic Clin Pharmacol Toxicol 2013;112(4):282–286. DOI: 10.1111/bcpt.12027.
  3. Lawrence J Cheskin, Manuel Franco, Daniel J Hoffman. Encyclopedia of Human Nutrition, 4th edition. ScienceDirect 2023. Available from:
  4. Abhilash KPP, Murugan S, Rabbi NAS, Pradeeptha S, Kumar S, Selvaraj B, et al. Deliberate self-poisoning and harm: A meticulous quest of methods in vogue. J Fam Med Prim Care 2022;11(1):233–239. DOI: 10.4103/jfmpc.jfmpc_1184_21.
  5. Mohamed F, Gawarammana I, Robertson TA, Roberts MS, Palangasinghe C, Zawahir S, et al. Acute human self-poisoning with imidacloprid compound: A neonicotinoid insecticide. PLOS One 2009;4(4):e5127. DOI: 10.1371/journal.pone.0005127.
  6. Tomizawa M, Casida JE. Neonicotinoid insecticide toxicology: Mechanisms of selective action. Annu Rev Pharmacol Toxicol 2005;45(1):247–268. DOI: 10.1146/annurev.pharmtox.45.120403.095930.
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