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Tang Y, Chen H, Qiu W, et al. Plasma Concentration After the First Hemoperfusion has a High Predictive Value in Medium Level Acute Paraquat-Poisoned Patients. Ther Drug Monit. 2021;43(6):797-806doi: 10.1097/FTD.0000000000000889.
Tang, Y., Chen, H., Qiu, W., Zhou, Y., Hong, G., Hu, L., Zhao, G., Chen, X., Zhi, S., & Lu, Z. (2021). Plasma Concentration After the First Hemoperfusion has a High Predictive Value in Medium Level Acute Paraquat-Poisoned Patients. Therapeutic drug monitoring, 43(6), 797-806. https://doi.org/10.1097/FTD.0000000000000889
Tang, Yahui, et al. "Plasma Concentration After the First Hemoperfusion has a High Predictive Value in Medium Level Acute Paraquat-Poisoned Patients." Therapeutic drug monitoring vol. 43,6 (2021): 797-806. doi: https://doi.org/10.1097/FTD.0000000000000889
Tang Y, Chen H, Qiu W, Zhou Y, Hong G, Hu L, Zhao G, Chen X, Zhi S, Lu Z. Plasma Concentration After the First Hemoperfusion has a High Predictive Value in Medium Level Acute Paraquat-Poisoned Patients. Ther Drug Monit. 2021 Dec 01;43(6):797-806. doi: 10.1097/FTD.0000000000000889. PMID: 34780392.
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Ther Drug Monit. 2021 Dec 01;43(6):797-806. doi: 10.1097/FTD.0000000000000889.

Plasma Concentration After the First Hemoperfusion has a High Predictive Value in Medium Level Acute Paraquat-Poisoned Patients.

Therapeutic drug monitoring

Yahui Tang, Hui Chen, Weiyong Qiu, Yanxue Zhou, Guangliang Hong, Lufeng Hu, Guangju Zhao, Xiaorong Chen, Shaoce Zhi, Zhongqiu Lu

Affiliations

  1. Department of Emergency Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou.
  2. Department of Intensive Care Medicine, Yiwu Hospital Affiliated to Wenzhou Medical University.
  3. Department of Nephrology, Yiwu Hospital Affiliated to Wenzhou Medical University, Yiwu; and.
  4. Department of Pharmacy, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

PMID: 34780392 DOI: 10.1097/FTD.0000000000000889

Abstract

BACKGROUND: Paraquat ( PQ) is very poisonous to humans and animals and there is no effective clinical antidote . The efficacy of hemoperfusion (HP) treatment for PQ poisoning remains controversial. To explore new ways to predict the prognosis of patients with acute PQ poisoning and assist in the development of better hemopurification treatment strategies.

METHODS: The clinical data of patients who were intoxicated with PQ through contact were diagnosed with PQ poisoning by high-performance liquid chromatography. Samples were collected by the Emergency Intensive Care Unit of the First Affiliated Hospital of Wenzhou Medical University from January 2012 to November 2016. Based on the prognosis, the patients were grouped into survival and death groups. Comparisons of the differences in the clinical indexes were performed, including the initial concentration of PQ at admission, PQ concentration after first HP, the number of HP cartridges used for the first hemoperfusion, whether HP was combined with continuous renal replacement therapy, and the number of concurrent organ injuries between the 2 groups. In addition, data were analyzed using multivariate logistic regression models and receiver operating characteristic curves. Moreover, prognostic factors in patients with acute PQ poisoning were analyzed.

RESULTS: Overall, 128 patients with acute PQ poisoning were enrolled in this study. The median plasma PQ concentrations of the patients at admission were 21 and 834 ng/mL (range: 50-1,099,118 ng/mL). The multiple logistic regression model revealed that the initial concentration of PQ and the PQ concentration after the first perfusion were independent risk factors for death in patients with acute PQ poisoning. The PQ concentration in the survival group after the first HP was <516 ng/mL and was mainly distributed at approximately 100 ng/mL. The percentage of patients whose concentration after the first HP was <516 ng/mL in the death group was only 19%.

CONCLUSIONS: The initial plasma PQ concentration after admission and PQ concentration after the first HP are risk factors for death in patients with acute PQ poisoning. Moreover, PQ concentration after the first HP had a high predictive value for death. When the initial plasma PQ concentration after admission ranges from 50 ng/mL to 5000 ng/mL, the rapid reduction in plasma PQ concentration after HP treatment could improve the prognosis of patients with acute PQ poisoning.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

The authors declare no conflict of interest.

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