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Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication

Paraquat (PQ) has known negative human health effects, but continues to be commonly used worldwide as a herbicide. Our clinical data shows that the main prognostic factor is the time required to achieve a negative urine dithionite test. Patient survival is a 100% when the area affected by ground gla...

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Autores principales: Gil, Hyo-wook, Hong, Jung-Rak, Jang, Si-Hyong, Hong, Sae-Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Academy of Medical Sciences 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234908/
https://www.ncbi.nlm.nih.gov/pubmed/25408572
http://dx.doi.org/10.3346/jkms.2014.29.11.1441
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author Gil, Hyo-wook
Hong, Jung-Rak
Jang, Si-Hyong
Hong, Sae-Yong
author_facet Gil, Hyo-wook
Hong, Jung-Rak
Jang, Si-Hyong
Hong, Sae-Yong
author_sort Gil, Hyo-wook
collection PubMed
description Paraquat (PQ) has known negative human health effects, but continues to be commonly used worldwide as a herbicide. Our clinical data shows that the main prognostic factor is the time required to achieve a negative urine dithionite test. Patient survival is a 100% when the area affected by ground glass opacity is <20% of the total lung volume on high-resolution computed tomography imaging 7 days post-PQ ingestion. The incidence of acute kidney injury is approximately 50%. The average serum creatinine level reaches its peak around 5 days post-ingestion, and usually normalizes within 3 weeks. We obtain two connecting lines from the highest PQ level for the survivors and the lowest PQ level among the non-survivors at a given time. Patients with a PQ level between these two lines are considered treatable. The following treatment modalities are recommended to preserve kidney function: 1) extracorporeal elimination, 2) intravenous antioxidant administration, 3) diuresis with a fluid, and 4) cytotoxic drugs. In conclusion, this review provides a general overview on the diagnostic procedure and treatment modality of acute PQ intoxication, while focusing on our clinical experience.
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spelling pubmed-42349082014-11-18 Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication Gil, Hyo-wook Hong, Jung-Rak Jang, Si-Hyong Hong, Sae-Yong J Korean Med Sci Review Paraquat (PQ) has known negative human health effects, but continues to be commonly used worldwide as a herbicide. Our clinical data shows that the main prognostic factor is the time required to achieve a negative urine dithionite test. Patient survival is a 100% when the area affected by ground glass opacity is <20% of the total lung volume on high-resolution computed tomography imaging 7 days post-PQ ingestion. The incidence of acute kidney injury is approximately 50%. The average serum creatinine level reaches its peak around 5 days post-ingestion, and usually normalizes within 3 weeks. We obtain two connecting lines from the highest PQ level for the survivors and the lowest PQ level among the non-survivors at a given time. Patients with a PQ level between these two lines are considered treatable. The following treatment modalities are recommended to preserve kidney function: 1) extracorporeal elimination, 2) intravenous antioxidant administration, 3) diuresis with a fluid, and 4) cytotoxic drugs. In conclusion, this review provides a general overview on the diagnostic procedure and treatment modality of acute PQ intoxication, while focusing on our clinical experience. The Korean Academy of Medical Sciences 2014-11 2014-11-04 /pmc/articles/PMC4234908/ /pubmed/25408572 http://dx.doi.org/10.3346/jkms.2014.29.11.1441 Text en © 2014 The Korean Academy of Medical Sciences. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Gil, Hyo-wook
Hong, Jung-Rak
Jang, Si-Hyong
Hong, Sae-Yong
Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication
title Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication
title_full Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication
title_fullStr Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication
title_full_unstemmed Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication
title_short Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication
title_sort diagnostic and therapeutic approach for acute paraquat intoxication
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4234908/
https://www.ncbi.nlm.nih.gov/pubmed/25408572
http://dx.doi.org/10.3346/jkms.2014.29.11.1441
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