Korean Journal of Nephrology 2010;29(5):554-561.
Plasma Paraquat Concentration and Early Prognostic Factors in Paraquat Poisoning
WonSuk Choi, M.D.2, Ja Hyun Kim, M,D.3, Hyun A Lee, M,D.2, KyungHong Jun, M.D.1, MyungSoo Kang, M.D.1 and Hyang Kim, M.D.2
Departments of Internal Medicine1
Eumseong Keumwang Hospital, Eumseong, Korea Departments of Internal Medicine2
Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Republic of Korea, Department of Occupational & Environmental Medicine3
Masan Samsung Hospital, Sungkyunkwan University school of Medicine, Masan, Republic of Korea
원저 : 파라캇 중독 환자에서 파라캇 혈중농도와 조기 예후 예측인자
최원석2, 김자현3, 이현아2, 전경홍1, 강명수1, 김향2
음성금왕삼성병원 내과1 , 성균관의대 강북삼성병원 내과2 , 마산삼성병원 산업의학과3
Abstract
Purpose: Paraquat is a lethal herbicide and induces acute renal failure, hepatic dysfunction, and progressive respiratory failure. The aims of this study are to investigate the correlation between plasma paraquat concentrations and initial laboratory data at Emergency Medical Center and to investigate whether initial laboratory data is useful for predicting outcomes of paraquat-poisoned patients. Methods: A retrospective analysis by chart review was done on 83 patients who ingested paraquat and who had presented to Emergency center of within 24 hours. Plasma paraquat concentrations, urine dithionite test and initial laboratory parameters including white blood cell count, urine pH, and AST, ALT, BUN, Creatinine, Amylase, Glucose, pH, PaCO2, PaO2, HCO3. Base Excess, Na, K, Cl were obtained at the time of Emergency Center visit. We compared urine dithionite test, plasma paraquat concentrations and Severity Index of Paraquat Pisoning (SSPI) of the survival group to those of the dead group. The patients were divided into four subgroups based on the level of plasma paraquat concentration, their initial laboratory data was compared and analyzed. Results: The mean plasma paraquat concentration in the mortality group was higher than that in the survival group (88.44±81.56 vs. 1.32±1.72 μg/mL). Among the initial laboratory data of four subgroups, WBC, Glucose, Cr, pH, HCO3, Bass excess were significantly different between the group of low level of plasma paraquat concentration and higher group. ANCOVA analysis revealed that WBC, HCO3, Bass excess correlated with the level of plasma paraquat concentration significantly. Conclusion: The plasma paraquat concentration and SIPP were higher in the mortality group significantly. Initial laboratory data including WBC, Glucose, Cr, pH, HCO3, Bass excess were proven to be significant prognostic factors. Especially WBC, HCO3, Bass excess can be used to predict the outcome of paraquat poisoning.
Key Words: Paraquat, Prognosis, Poisoning
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