title: Paraquat poisoning in pediatric patients.
abstract: OBJECTIVE
  This observational study examined the outcome of Taiwanese pediatric patients with paraquat poisoning and compared these data with the published data on paraquat poisonings from other international poisoning centers.
  
  
  METHODS
  We performed a retrospective study on children with acute paraquat poisoning that were admitted to the Chang Gung Memorial Hospital during a period of 10 years (2000-2010). Of the 193 paraquat poisoning patients, only 6 were children.
  
  
  RESULTS
  The mean age was 8.85 ± 5.55 (1-15.6) years. Younger patients had accidentally swallowed paraquat, whereas older patients had intentionally ingested paraquat. Most patients were referred within a relatively short period (0.5-2.0 hours). Paraquat poisoning was associated with high morbidity and often resulted in severe complications, including acute respiratory distress syndrome and multiple-organ failure. The complications included shock (50.0%), hypoxemia (33.3%), respiratory failure (33.3%), nausea/vomiting (16.7%), abdominal pain (33.3%), hepatitis (66.7%), gastrointestinal tract bleeding (33.3%), acute renal failure (33.3%), and seizures (16.7%). Patients were treated aggressively with a standard detoxification protocol consisting of gastric lavage, active charcoal, charcoal hemoperfusion, and cyclophosphamide and steroid pulse therapies. Secondary bacterial infections were common after hospitalization and included sepsis (33.3%), pneumonia (33.3%), and urinary tract infection (50.0%). In the end, 2 patients (33.3%) died from multiple-organ failure, despite intensive resuscitation.
  
  
  CONCLUSIONS
  Our data (mortality rate, 33.3%) are comparable to the data of other published reports from other international poison centers. Evidently, a prompt diagnosis of paraquat poisoning and an immediate institution of a detoxification protocol is a prerequisite for a favorable outcome.
authors.affiliation: Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Hsieh
authors.forename: Ja-Liang
authors.initials: JL
authors.lastname: Lin
authors.forename: Shen-Yang
authors.initials: SY
authors.lastname: Lee
authors.forename: Cheng-Hao
authors.initials: CH
authors.lastname: Weng
authors.forename: Huang-Yu
authors.initials: HY
authors.lastname: Yang
authors.forename: Shou-Hsuan
authors.initials: SH
authors.lastname: Liu
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Tzung-Hai
authors.initials: TH
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010269:Paraquat / Q000506:poisoning*; D012189:Retrospective Studies; D013624:Taiwan
chemical_list: D010269:Paraquat