title: Clinical implications of the ethane in exhaled breath in patients with acute paraquat intoxication.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea.
authors.forename: Sae-Yong
authors.initials: SY
authors.lastname: Hong
authors.forename: Hyo-Wook
authors.initials: HW
authors.lastname: Gil
authors.forename: Jong-Oh
authors.initials: JO
authors.lastname: Yang
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Lee
authors.forename: Joo-Ock
authors.initials: JO
authors.lastname: Na
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Seo
authors.forename: Yong-Hoon
authors.initials: YH
authors.lastname: Kim
mesh_terms: 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
chemical_list: D015415:Biomarkers; D005609:Free Radicals; D006540:Herbicides; D004980:Ethane; D010269:Paraquat