Usefulness of Hemoperfusion in Paraquat Poisoning

Choi, Won Seok; Jung, Eun Haeng; Park, Eun Hye; Seo, Jung Yeon; Jun, Kyung Hong; Kang, Myung Soo; Kim, Hyang

Abstract

BACKGROUND/AIMS
Paraquat is a potentially lethal herbicide that induces acute renal failure, hepatic dysfunction, and progressive respiratory failure. This study examined the usefulness of hemoperfusion in paraquat poisoning.
METHODS
We reviewed the medical records of 27 patients who underwent hemoperfusion after paraquat poisoning at Eumseong Keumwang Hospital from January 2009 to January 2010.
RESULTS
All 27 paraquat-poisoning patients underwent hemoperfusion therapy within 6 hours of ingestion, and 13 patients survived. Patients who had ingested more than four mouthfuls died with 24 hours despite hemoperfusion. The mean arrival time at the emergency room and the plasma paraquat concentration in the survivors was 3.08 hours and 1.30 microg/mL, respectively; after hemoperfusion, the mean elapsed time was 8.92 hours and the plasma paraquat level was 0.14 microg/mL. The mean arrival time at the emergency room and plasma paraquat concentration in the non-survivors was 2.93 hours and 50.52 microg/mL, respectively; after hemoperfusion, the mean elapsed time was 9.36 hours, and the plasma paraquat level was 40.52 microg/mL.
CONCLUSIONS
Urgent hemoperfusion therapy is essential for complete recovery from paraquat poisoning in patients who do not have metabolic acidosis or renal failure. However, hemoperfusion is not effective in those who ingested large amount of paraquat or have a urine dithionite of 4+, metabolic acidosis, or acute renal failure.