A New Statistical Approach to the Prognostic Significance of Plasma Paraquat Concentrations

Hart, Taylor; Nevitt, A.; Whitehead, A.

doi:10.1016/s0140-6736(84)92784-3

Cited by 149 publications

(83 citation statements)

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“…Paraquat is an extremely lethal pesticide and is often taken intentionally in suicides. Intestinal lavage, blood adsorption, steroid pulse therapy, and various other treatments have been attempted, but case fatality rates are extremely high 6,7) . In research over 15 years by Fukuoka Medical College 8) , 91 out of 115 deaths from pesticide poisoning were from paraquat (78% case fatality rate), followed by 3 deaths caused by organophosphates (4% case fatality rate).…”

Section: Discussionmentioning

confidence: 99%

Deaths from Pesticide Poisoning in Japan, 1968-2005: Data from Vital Statistics

Ito

Nakamura

2008

J Rural Med

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Objective: We analyzed the number of deaths due to poisoning by pesticides over 38 years through vital statistics published annually by the Ministry of Health, Labour and Welfare of the Japanese government, from 1968 through 2005. Materials and Methods: Data not published as vital statistics were obtained from the Ministry of Health, Labour and Welfare Statistics and Information Department. The vital statistics provide the numbers of deaths with individual causes of death classified by sex and 5-year age group. We also calculated age-adjusted death rates by this classification, using a direct method based on the 1985 Japanese model population.

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Section: Discussionmentioning

confidence: 99%

Deaths from Pesticide Poisoning in Japan, 1968-2005: Data from Vital Statistics

Ito

Nakamura

2008

J Rural Med

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“…A paraquat blood level of >1.6 μg/mL 12 h after ingestion is universally lethal. 8 Initial management focuses on prevention of further absorption and gastrointestinal decontamination. Adsorbents like activated charcoal (1-2 g/kg) and Fuller's earth (1-2 g/kg); given with a cathartic such as 70% sorbitol should be given as soon as possible.…”

Section: Resultsmentioning

confidence: 99%

Clinical spectrum and outcome of paraquat poisoning in a tertiary care teaching hospital

Halesha

Venugopal

2018

Int J Adv Med

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Background: Paraquat is most common insecticide compound used for suicidal consumption in rural part of the Karnataka next to organo-phosphorous compound. It produces various local and systemic manifestations in the early course. It is very notorious to cause multi-organ dysfunction and mortality within 24 hours in severe amount of consumption. Lack of specific antidote and high-quality evidence based medicine makes the management of paraquat poisoning challenging. Hence, we took up the study to evaluate the clinical features, course and management option for the poisoning.Methods: It is an observational study conducted at HIMS, Hassan. History was collected from patient and bystanders. Clinical features, laboratory parameters were noted regularly and frequently. Patient’s complications were identified initially and treated accordingly. All the data collected were tabulated and statistically analysed.Results: Out of 110 patients, 72 were females and 38 were males; most of them were in the age group of 30-40 years. Mild poisoning was noted in 30, moderate in 56 and 24 patients were severe. Most common symptom was nausea and signs were oral cavity ulcers followed by tachycardia and tachypnoea. The overall mortality was 72%, 18% were recovered fully and 10% patients left against medical advice.Conclusions: Since there is a lack of antidote management of paraquat is challenging. Early gastric lavage, aggressive fluids, IV methyl prednisolone and N-Acetyl-Cysteine is beneficial.

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“…According to the survival probability employing Proudfoot's criteria [9] or Scherrmann's predictive value of plasma paraquat concentration [10], this patient was initially classified as likely to die. According to the Hart nomogram [11], his predicted survival rate was of 20-30%. He was most likely to die from pulmonary fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Delayed immunosuppressive treatment in life-threatening paraquat ingestion: A case report

et al. 2009

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Introduction: Combined glucocorticoids and cyclophosphamide pulse therapy showed promising results in moderate-to-severe paraquat poisonings to reduce life-threatening respiratory complications. Its benefit has been observed when given early in the course of poisoning; however, whether its delayed administration remains beneficial is unknown.Case Report: We describe a 23-year-old male who ingested 70 mL of a commercialized concentrate formulation with 20% weight/volume paraquat in a suicide attempt. Within 24 hours from paraquat ingestion, he presented most of the indicators of poor outcome, including gastritis, early renal dysfunction, dark blue urine colorimetric dithionite test, and marked plasma paraquat concentrations (0.56 g/mL at 13 hours, and 0.41 g/mL at 24 hours after ingestion). The patient received early gastrointestinal decontamination and aggressive supportive treatments. However, due to a rapidly progressive severe pulmonary infection, glucocorticoids and cyclophosphamide were delayed until day 14. Interestingly, our patient survived with mild respiratory sequelae despite poor initial prognosis.Discussion: This observation suggests the potential benefit of immunosuppressive pulse therapy, even if administered 14 days after paraquat ingestion, and highlights the role of paraquat-induced alveolitis in the development of fibrosis.Conclusion: Combined glucocorticoids and cyclophosphamide should be considered in moderate-to-severe paraquat poisonings, even if delayed.

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A New Statistical Approach to the Prognostic Significance of Plasma Paraquat Concentrations

Cited by 149 publications

References 1 publication

Deaths from Pesticide Poisoning in Japan, 1968-2005: Data from Vital Statistics

Deaths from Pesticide Poisoning in Japan, 1968-2005: Data from Vital Statistics

Clinical spectrum and outcome of paraquat poisoning in a tertiary care teaching hospital

Delayed immunosuppressive treatment in life-threatening paraquat ingestion: A case report

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