Clinical implications of the ethane in exhaled breath in patients with acute paraquat intoxication.
OBJECTIVE
Pulmonary fibrosis due to lipid peroxidation is a major symptom of paraquat intoxication. Ethane in the expired breath (exEth) reflects lipid peroxidation and may be a measure of the damage effected by oxygen radicals in acute lung injury. The purpose of this study was to evaluate the clinical efficacy of exEth as a measure of exposure to paraquat and as an indicator of lung damage.


METHODS
Exposure levels were evaluated by the amount ingested, semiquantitative measurement of urine paraquat levels, and plasma paraquat concentration. End-tidal breath was collected for measurement of ethane 24 h after paraquat ingestion. Renal function and blood gas analyses were conducted on the same day as the breath collection, and the final clinical outcome was defined as either recovery or death. Associations between exEth and paraquat exposure profiles and clinical outcomes were assessed using linear regression models.


METHODS
Twenty-one patients poisoned by paraquat were selected for the study during 2001 and 2002.


RESULTS
exEth could not be used as a predictor of laboratory parameters such as Pa(O2), Pa(CO2), serum creatinine, and lung injury (as graded by high-resolution CT). A logistical analysis revealed that only the amount of paraquat ingested was a significant predictor of fatality (p = 0.021). The strength of the association between exEth and fatality was unaffected by the addition of potential confounders such as age, sex, and time interval and paraquat concentration.


CONCLUSIONS
exEth cannot be used as either an independent predictor of survival or a specific marker of lung injury in patients with acute paraquat poisoning.
Hong
Sae-Yong
SY
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
Gil
Hyo-Wook
HW
Yang
Jong-Oh
JO
Lee
Eun-Young
EY
Na
Joo-Ock
JO
Seo
Ki-Hyun
KH
Kim
Yong-Hoon
YH
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests; D004980:Ethane; D005260:Female; D005609:Free Radicals / Q000032:analysis; D006540:Herbicides / Q000506:poisoning*; D006801:Humans; D015227:Lipid Peroxidation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010269:Paraquat / Q000506:poisoning*; D011237:Predictive Value of Tests; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000139:chemically induced* / Q000503:physiopathology
D015415:Biomarkers; D005609:Free Radicals; D006540:Herbicides; D004980:Ethane; D010269:Paraquat