Review of a Case of Paraquat Poisoning in a Tertiary Care Rural-based ICU

Paraquat (1,1′-dimethyl-4, 4′-dipyridylium) is a broad-spectrum liquid herbicide associated with both accidental and intentional ingestion leading to severe and often fatal toxicity.(1) Paraquat is actively taken up against a concentration gradient into lung tissue leading to pneumonitis and lung fibrosis. Paraquat also causes renal and liver injury.(2) There are few case publications of paraquat poisoning and only few of them have reported that renal failure has ensued before acute respiratory distress syndrome (ARDS). Our patient presented with above lethal dose intake of paraquat containing substance and we did gastric lavage followed by charcoal hemoperfusion and hemodialysis but patient could not be saved despite optimum efforts suggesting the high fatality of this kind of poisoning. HOW TO CITE THIS ARTICLE: Sharma DS, Prajapati AM, Shah DM. Review of a Case of Paraquat Poisoning in a Tertiary Care Rural-based ICU. Indian J Crit Care Med 2019;23(6):284–286. KEY MESSAGES: Acute renal injury with hypoperfusion state due to toxicity at cellular level, redox cycling and intracellular reactive oxidative stress generation may also cause death in early stages in paraquat poisoning despite optimal management.