Hypokalemia is a biochemical signal of poor prognosis for acute paraquat poisoning within 4 hours.

Anecdotal reports have suggested that hypokalemia is an independent predictor of mortality in patients with acute paraquat poisoning. However, the clinical significance of hypokalemia has not been systematically investigated in the early stage of paraquat poisoning. This study aimed to evaluate whether initial hypokalemia is a good predictor of mortality in patients with acute paraquat poisoning within 4 h. We retrospectively analyzed patients who were admitted to the emergency department after paraquat poisoning between September 2012 and January 2015. Demographic, clinical, and laboratory data were recorded, and the prognostic significance of hypokalemia was analyzed. A total of 120 patients were included. The 60-day mortality was 71.7 %. Serum potassium concentrations were significantly lower in non-survivors (3.1 ± 0.5 mmol/L) than in survivors (3.8 ± 0.3 mmol/L, P < 0.001). Independent predictors of death were amount of paraquat ingested (hazard ratio 1.005; 95 % confidence interval 1.002-1.007), serum potassium (0.498, 0.277-0.897), bicarbonate (0.934, 0.876-0.995), and white blood cell count (1.032, 1.001-1.065). For receiver operating characteristic curve analysis, serum potassium had an area under the curve of 0.852 (95 % confidence interval 0.784-0.920, P < 0.001), and the best cutoff value was 3.5 mmol/L (sensitivity, 88.2 %; specificity, 75.6 % in predicting survivors). Kaplan-Meier analysis showed that decreased serum potassium concentrations were associated with an increase in 60-day mortality (P < 0.001). Hypokalemia may be a reliable predictor in evaluating prognosis in paraquat poisoning within 4 h. The mechanism is not clear, and further studies verifying the precise mechanism of hypokalemia are required.

[Evaluation of therapeutic project on acute tetramethylene disulphotetramine poisoning and effect on intelligence in children].

OBJECTIVE: To evaluate four therapeutic measures on acute tetramethylene disulphotetramine (TETS) poisoning and the effects of it on intelligence of children. METHODS: All 86 patients of acute TETS poisoning were randomly divided into 4 groups (the control group, sodium valproate group, sodium dimercaptopropane sulfonate group and the hemoperfusion group). The therapeutic effects were observed after the arranged treatment was administrated. According to age, residence, sex, education and domestic economy, 30 children were matched by 1:1 with children of TETS poisoning. RESULTS: The termination time of seizure, doses of diazepam, mental symptoms and the continual time of mental symptoms were not significantly different among these three groups. After hemoperfusion, the seizure of patients was terminated or the frequency was obviously decreased, but the level of TETS in blood was not reduced. The average scores of full intelligence quotient (FIQ), the verbal intelligence quotient (VIQ) and the performance intelligence quotient (PIQ) of children in poisoning group were 9.1, 8.8 and 7.7 less than the controls. The average scores of FIQ of children with bad state were 15 less than the controls. CONCLUSION: Therapeutic effects of sodium valproate and sodium dimercaptopropane sulfonate on acute TETS poisoning should be not better than using diazepam and sodium phenobarbital. Therapeutic effects of hemoperfusion on TETS poisoning is good. TETS poisoning should have a great influence on intelligence of children.