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Effect of Aggressive Haemoperfiusion on the Clinical Course of Patients with Paraquat Poisonin

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Nobukatsu Takasu

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Toru Okabe

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Shinichi Ishimatsu

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Akinori Ueda

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Shigeru Tanaka

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Atsuhiro Fukuda

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Seizaburo Arita

Department of Mathematics, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

Akitsugu Kohama

Department of Emergency and Critical Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-01 Japan

The effect of aggressive haemoperfusion; i.e. haemoperfusion of 10 h or more during the first 24 h after ingestion, on the clinical course of paraquat poisoning was studied. Among 40 patients admitted within 15 h after ingestion of paraquat with an SIPP of less than 100 (h x µg ml^-1), 21 received aggressive haemoperfusion and 19 received conventional haemoperfusion; i.e. haemoperfusion of less than 10 h during the same period. Survival rates of patients with severity between an SIPP of 100 and Proudfoof's curve in the two groups were compared by the log-rank test. Aggressive haemoperfusion did not improve the outcome but did improve the survival rates; that is, the number of patients surviving at particulalr points in time (P<0,05). The length of haemoperfusion for the aggressive haemoperfusion group was longer than that for the conventional group on the first day (P<0.001 ), but the difference was insignificant during the following two days. Neither the time from ingestion to haemoperfusion, urine volume from the first to third day, nor initial plasma-paraquat concentrations and SIPP were significant between groups. These findings imply that aggressive haemoperfusion reduces the severity of paraquat poisoning and elongates survival time. We, therefore, propose that the efficacy of more aggressive haemoperfusion, such as the 'continuous haemoperfusion' proposed by Okonek et al., should be further studied.

Human & Experimental Toxicology, Vol. 12, No. 4, 323-327 (1993)
DOI: 10.1177/096032719301200411


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