Poisoning Treatment India

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

Poisoning Treatment India

Paraquat (PQ) is a water-soluble organic heterocyclic herbicide (1,1-dimethyl-4,4-bipyridine cationic salt) with an apparent distribution volume of 1 liter/kg [1, 2] . PQ is very toxic to human and animals and is without any specific antidote. The oral lethal dose is 1–6 g and the lethal concentration is 3 g/ml [3] . The toxicity of PQ might be due to its accumulation in the alveolar cells resulting in lipid oxidation by free radicals of the cell membranes in the lung, kidney, and liver, and manifesting as pulmonary hemorrhage, edema, fibrosis, and liver and kidney damage [4] . Treatments include emetics, gastric lavage, catharsis, diuretics, reduced glutathione, glucocorticoid, and organ function support [5–7] . The toxicokinetics of PQ in humans is not entirely clear, and most knowledge is obtained from animal studies. The gastrointestinal absorption rate of PQ is low and most of PQ is excreted through the feces. The peak serum concentration appears 2–4 h after oral absorp- For conservative treatment, patients received an emetic (sodium bicarbonate solution or activated carbon suspension of 200 ml injected into the stomach); gastric lavage (15% bleaching clay suspension or 15% activated carbon suspension); catharsis (15% bleaching clay suspension or 15% activated carbon suspension, 300 ml with 20% mannitol, 250 ml); promotion of PQ excretion by fluid infusion and diuresis. Organ function supportive therapy included oxygen supply, mechanical ventilation, expanding blood volume, and administration of vasoactive drugs to maintain appropriate tissue perfusion and cell metabolism when necessary.