title: Comparison between kidney and continuous plasma perfusion for paraquat elimination.
abstract: BACKGROUND
  Thousands of paraquat (PQ)-poisoned patients continue to die. Plasma perfusion (PP) has recently been incorporated as a method of clinical detoxification. The purpose of this study was to estimate the PQ clearance of PP and observe the effect of PP on PQ concentration in the blood of patients with acute PQ poisoning.
  
  
  METHODS
  Twenty one PQ-poisoned patients admitted to our poisoning center within 24 hours after the ingestion were prospectively enrolled. Continuous plasma perfusion was performed. Urinary PQ and plasma PQ concentration level at inlet/outlet of the cartridge were obtained right before and 1.5 hours after the start of each perfusion session for the calculation of renal and plasma PQ excretion.
  
  
  RESULTS
  In all 8 rounds (108 sessions) of PP on the 21 patients, PQ clearance rate (mL/min) by PP was always found to be higher than the renal value: (1st 11.14 ± 6.13 versus 6.53 ± 1.46; 2nd 18.36 ± 11.32 versus 6.23 ± 1.51; 3rd 16.13 ± 10.05 versus 4.01 ± 0.93; 4th 12.86 [6.72, 17.47] versus 2.42 [0.65, 4.20]; 5th 14.12 [10.48, 35.20] versus 1.77 [0.63, 2.91]; 6th 16.47 [11.82; 20.69] versus 1.70 [0.23, 3.18]; 7th 13.33 [9.71, 18.75] versus 1.10 [0.14, 2.99]; 8th 11.27 [9.21, 16.02] versus 1.10 [0.09, 2.79], P < 0.05). The survivors showed a higher plasma PQ reduction rate (mg L hour) than the nonsurvivors (0.57 ± 0.03 versus 0.47 ± 0.06, P < 0.05).
  
  
  CONCLUSIONS
  Our data show that PP therapies help in the clearance of PQ and may prove a promising therapeutic tool in patients with acute PQ intoxication.
authors.affiliation: Graduate School of Tianjin Medical University (G-QL), Tianjin, China; and Departments of Intensive Care Medicine (G-QL, L-QW, YL, Y-HZ), Department of Cardiology (Y-ML), Affiliated Hospital of the Medical College of the Chinese People's Armed Police Forces, Tianjin, China.
authors.forename: Guo-Qiang
authors.initials: GQ
authors.lastname: Li
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Li
authors.forename: Lu-Qing
authors.initials: LQ
authors.lastname: Wei
authors.forename: Yang
authors.initials: Y
authors.lastname: Liu
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006540:Herbicides / Q000097:blood / Q000506:poisoning; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010269:Paraquat / Q000097:blood* / Q000506:poisoning*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D006540:Herbicides; D010269:Paraquat