Continuous hemoperfusion relieves pulmonary fibrosis in patients with acute mild and moderate paraquat poisoning

Xiao, Qingmian; Wang, Weizhan; Qi, Hongna; Gao, Xun; Zhu, Baoyue; Li, Jing; Wang, Pu

doi:10.2131/jts.45.611

Cited by 9 publications

(15 citation statements)

References 14 publications

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“…9 After absorption, paraquat is rapidly distributed to the liver, kidneys, lungs, and other organs. 2 The volume distribution of paraquat is 1.2 to 1.6 L kg À1 , and the unchanged drug excretion rate up to 48 hours (not metabolized, predominantly urinary) is 82.9%. 10,11 Once paraquat is distributed into deeper body tissues, it is slowly eliminated over several days to weeks.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Paraquat is highly toxic to humans; the main prognostic factors of paraquat absorption are pulmonary damage and fibrosis. 1 , 2 , 8 Paraquat can rapidly enter the body through ingestion and skin absorption. 9 After absorption, paraquat is rapidly distributed to the liver, kidneys, lungs, and other organs.…”

Section: Discussionmentioning

confidence: 99%

“… 1 The herbicide is absorbed through the digestive tract and skin and causes multiple organ damage. 2 Skin exposure to paraquat can result in local redness and swollen cankers. 3 Only a few cases of visceral damage from paraquat poisoning via skin absorption have been recorded.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The toxicokinetics of acute paraquat poisoning in specific patients: a case series

Shi

et al. 2022

J Int Med Res

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Paraquat is a non-selective contact herbicide that is absorbed through the digestive tract and skin and can cause multiple organ damage. The toxicokinetics of paraquat poisoning in specific patients are rarely reported. Case 1 was a 76-year-old man who intermittently immersed his perineum in diluted paraquat solution for 3 consecutive days because of eczema of the perineal skin. On admission, the patient’s scrotal skin was severely corroded and his blood paraquat concentration was 0.5 μg/mL. He developed severe kidney and lung damage after admission and died on Day 6 of admission. Case 2 was a 23-year-old woman who ingested paraquat during gestational week 36. Her initial blood paraquat concentration was 0.81 μg/mL. The patient refused hemoperfusion and a cesarean section. She birthed a baby girl 83 hours after ingesting paraquat. Paraquat concentrations in postnatal maternal blood, fetal blood, umbilical cord blood, and amniotic fluid were 0.19 μg/mL, 0.23 μg/mL, 0.20 μg/mL, and 0.47 μg/mL, respectively. The baby died within hours of birth and the mother died of refractory respiratory failure 2 days after delivery. This paper provides clues about paraquat toxicokinetics in specific patient types and indicates that paraquat can be absorbed through the scrotal skin and the placental barrier.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The toxicokinetics of acute paraquat poisoning in specific patients: a case series

Shi

et al. 2022

J Int Med Res

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“…Owing to the lack of a specific antidote, it is necessary to reduce absorption and enhance elimination in oral diquat poisoning ( 1 ). Hemoperfusion is a common method for removing toxins from the blood, and hemofiltration is used for treating acute renal failure and rhabdomyolysis ( 18 , 19 ). In this case report, diquat concentration in the blood was reduced via hemoperfusion and hemofiltration.…”

Section: Discussionmentioning

confidence: 99%

Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis

Wang²,

Jian³

et al. 2022

Front. Public Health

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Diquat is a herbicide that can have deleterious effects on the kidneys, liver, heart, lungs, and central nervous system on ingestion. Diquat poisoning-associated rhabdomyolysis has rarely been reported. We describe two cases of diquat poisoning with acute renal failure, myocardial damage, and rhabdomyolysis. Case 1: A 17-year-old man experienced anuria after ingesting ~200 mL of diquat 16 h prior. On admission, his creatinine (400 μmol/L), urea (11.7 mmol/L), creatine kinase (2,534 IU/L), and myohemoglobin (4,425 ng/mL) concentrations were elevated. Case 2: An 18-year-old woman who ingested ~200 mL of diquat 5.5 h prior to admission had normal creatinine, urea, and creatine kinase concentrations. Eleven hours after ingestion, she developed anuria with elevated creatinine (169 μmol/L) concentration; her creatine kinase (13,617 IU/L) and myohemoglobin (>3,811 ng/mL) concentrations were remarkably elevated 24 h after ingestion. Both patients also had elevated aminotransferase and myocardial enzyme concentrations. After undergoing hemoperfusion and hemofiltration, blood diquat concentrations in cases 1 and 2 on admission (16/6 h after ingestion), after hemoperfusion (20/11 h after ingestion), and after 8 h of hemofiltration/8 h of hemofiltration and 2 h of hemoperfusion (29/21 h after ingestion) were 4.9/9.1, 3.4/5.4, and 1.5/1.2 μg/mL, respectively. Severe diquat poisoning can cause acute kidney failure and rhabdomyolysis. Rhabdomyolysis may induce myocardial injury, aggravating kidney damage, and also increase transaminase concentration. Hemoperfusion and hemofiltration could be effective treatments for eliminating diquat in the blood.

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“…Several indications have been explored in relation to hemoperfusion in the setting of “ intoxication. ” As an example, they might include the treatment of intoxication with either a drug [ 43 – 45 ] (e.g., valproate, carbamazepine) or a toxic chemical (e.g., paraquat or organophosphates) [ 46 , 47 ] or toxic natural products [ 48 ] (e.g., mushroom-related toxins). Unfortunately, no controlled studies exist.…”

Section: When To Consider Hemoperfusionmentioning

confidence: 99%

Hemoperfusion: technical aspects and state of the art

Ronco

Bellomo

2022

Crit Care

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Background Blood purification through the removal of plasma solutes by adsorption to beads of charcoal or resins contained in a cartridge (hemoperfusion) has a long and imperfect history. Developments in production and coating technology, however, have recently increased the biocompatibility of sorbents and have spurred renewed interest in hemoperfusion. Methods We performed a narrative assessment of the literature with focus on the technology, characteristics, and principles of hemoperfusion. We assessed publications in ex vivo, animal, and human studies. We synthesized such literature in a technical and state-of-the-art summary. Results Early hemoperfusion studies were hampered by bioincompatibility. Recent technology, however, has improved its safety. Hemoperfusion has been used with positive effects in chronic dialysis and chronic liver disease. It has also demonstrated extraction of a variety of toxins and drugs during episodes of overdose. Trials with endotoxin binding polymyxin B have shown mixed results in septic shock and are under active investigation. The role of non-selective hemoperfusion in sepsis or inflammation remains. Although new technologies have made sorbents more biocompatible, the research agenda in the field remains vast. Conclusion New sorbents markedly differ from those used in the past because of greater biocompatibility and safety. Initial studies of novel sorbent-based hemoperfusion show some promise in specific chronic conditions and some acute states. Systematic studies of novel sorbent-based hemoperfusion are now both necessary and justified.

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Continuous hemoperfusion relieves pulmonary fibrosis in patients with acute mild and moderate paraquat poisoning

Cited by 9 publications

References 14 publications

The toxicokinetics of acute paraquat poisoning in specific patients: a case series

The toxicokinetics of acute paraquat poisoning in specific patients: a case series

Case series: Diquat poisoning with acute kidney failure, myocardial damage, and rhabdomyolysis

Hemoperfusion: technical aspects and state of the art

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