Document Detail


Hemoperfusion-hemodialysis ineffective for paraquat removal in life-threatening poisoning?
MedLine Citation:
PMID:  4057309     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report on a patient treated with hemoperfusion-hemodialysis (HP-HD) for severe paraquat poisoning. This procedure was adopted since the combination of adsorption and dialysis may improve overall drug removal. On admission blood paraquat was 15.8 micrograms/ml. He received conventional treatment and combined HP-HD which started within 3 hours after ingestion of the chemical and lasted 5 hours. Blood samples were obtained during and after HP-HD. The samples during HP-HD were taken before the charcoal column, between the charcoal column and the artificial kidney and after the artificial kidney. Blood clearances of paraquat were 116 +/- 32 ml/min (n=6) for the charcoal column (HP), 90 +/- 54 ml/min (n=6) for the artificial kidney (HD) and 151 +/- 37 ml/min (n=6) for the combined systems (HP-HD). After HP-HD a limited rebound of blood paraquat level was seen. One day after admission renal and hepatic failure had developed, and the patient died after 5 days. Tissue paraquat levels (microgram/g wet tissue) were: skeletal muscle 9.4, pancreas 6.0, prostate 5.6, thyroid 4.2, lungs 4.0, bone marrow 4.0, kidney 3.1, spleen 2.9, adrenal 2.9, heart 2.8, liver 2.3, stomach and testis below 1.0. Measurements of blood levels demonstrated the efficient clearances of paraquat with HP-HD from the central (plasma) compartment. However, the present results confirmed those previously reported which suggest that the efficiency of short HP-HD in treating severe paraquat poisoning is questionable since paraquat levels in the peripheral (tissue) compartment remain elevated.
Authors:
F L Van de Vyver; R A Giuliano; G J Paulus; G A Verpooten; J P Franke; R A De Zeeuw; L F Van Gaal; M E De Broe
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of toxicology. Clinical toxicology     Volume:  23     ISSN:  0731-3810     ISO Abbreviation:  J. Toxicol. Clin. Toxicol.     Publication Date:  1985  
Date Detail:
Created Date:  1985-12-09     Completed Date:  1985-12-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8213460     Medline TA:  J Toxicol Clin Toxicol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  117-31     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Hemoperfusion*
Humans
Kidney / pathology
Liver / pathology
Male
Paraquat / blood,  poisoning*
Renal Dialysis*
Chemical
Reg. No./Substance:
4685-14-7/Paraquat

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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