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Early Stage Blood Purification for Paraquat Poisoning: A Multicenter Retrospective Study

time :  2017-01-16

An Li, Wenxiong Li, Fengtong Hao, Haishi Wang,

Department of Occupational Diseases and Poisoning Medicine, Department of SICU, Beijing Chaoyang Hospital, Capital Medical University, Beijing, and Department of Occupational Medicine and Clinical Toxicology, Shandong

Provincial Hospital, Jinan, China


Abstract

Objectives: To evaluate the efficacy of conservative treatment vs. hemoperfusion (HP) vs. HP + continuous veno-venous hemofiltration (CVVH) for acute Paraquat (PQ) poisoning.

Methods: This was a multicenter retrospective study of patients with PQ poisoning between January 2013 and June 2014. Clinical data and PQ serum levels were collected at baseline and after 24, 48, and 72 h of treatment.

Results: Seventy- five, 65, and 43 underwent conservative treatment only (conservative treatment group), conservative treatment + HP (HP group), and conservative treatment + HP + CVVH (HP + CVVH group), respectively. PQ serum levels decreased in all groups after 72 h of treatment (p < 0.001); meanwhile, these values decreased faster in the HP and HP + CVVH groups compared with the conservative treatment group. More importantly, PQ blood levels were significantly lower in the HP + CVVH group compared with the HP group at 24 h (p < 0.05). Sequential organ failure assessment (ΔSOFA) values in the HP and HP + CVVH groups were significantly lower compared with that obtained for the conservative treatment group (p < 0.05). The 60-day survival rates were 21.3, 43.1 and 46.5%, respectively. Multivariate analysis indicated that age, PQ dose, admission PQ levels, and admission SOFA score were independently associated with mortality. HP and HP + CVVH were protective factors. 

Conclusion: Early HP or HP + CVVH after PQ poisoning could decrease PQ blood levels, alleviate organ damage, and increase survival.

Key Words: Paraquat · Poisoning · Hemoperfusion · Continuous veno-venous hemofiltration · Conservative treatment


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