title: Efficacy of gut lavage, hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication.
abstract: Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents. Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1-2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1-2 ppm, the clearance values for hemoperfusion were some 5-7 times higher than those for hemodialysis. In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquats less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.
mesh_terms: D000328:Adult; D002606:Charcoal / Q000627:therapeutic use; D004178:Diquat / Q000506:poisoning*; D005751:Gastric Lavage; D006801:Humans; D007422:Intestines; D008297:Male; D008875:Middle Aged; D010269:Paraquat / Q000506:poisoning*; D010477:Perfusion; D011041:Poisoning / Q000628:therapy; D011726:Pyridinium Compounds / Q000506:poisoning*; D006435:Renal Dialysis; D007507:Therapeutic Irrigation
chemical_list: D011726:Pyridinium Compounds; D002606:Charcoal; D004178:Diquat; D010269:Paraquat