Efficacy of Extracorporeal Extraction Treatment in Paraquat Poisoning

ABSTRACT

PURPOSE: The value of extracorporeal extraction in treating paraquat poisoning was questioned; some saved their patients by applying hemoperfusion, but others failed. This study was designed to investigate the efficacy of extracorporeal extraction treatment for patients suffering from paraquat poisoning. METHOD: The serum concentrations after ingestion of paraquat by 52 patients were serially checked. Of those 52, 42 were treated with hemoperfusion, and 34 of 42 patients were treated with continuous veno-venous hemodialysis (CVVH) after hemoperfusion. We evaluated the mortality, the survival time, and the hourly elimination rate of paraquat to investigate the efficacy of extracorporeal extraction. Also, we evaluated factors which affected the efficacy of the extracorporeal extraction. RESULT: There was no difference between the hemoperfusion group and the non-hemoperfusion group in mortality, time of survival, and elimination rate of paraquat (p>0.1). The total mortality was 50.0% (26/52) with no difference between the hemoperfusion group and the hemoperfusion +CVVH group. The mortality was closely related with the development of acute renal failure. Hemoperfusion, when applied before the collapse of the renal function, is effective in reducing mortality even in severe poisoning. Hemoperfusion had value in enhancing the hourly elimination rate of circulating paraquat in cases with renal collapse, but had little value in reducing mortality. CONCLUSION: The efficacy of extracorporeal extraction in treating patients with paraqaut poisoning was not proven in this study. However we suggest that early extracorporeal extraction may be effective in treating paraquat poisoning, even in severe cases, due to its possible detoxicating effect and toxin removal.