title: Early Stage Blood Purification for Paraquat Poisoning: A Multicenter Retrospective Study.
abstract: OBJECTIVE
  To evaluate the efficacy of conservative treatment vs. hemoperfusion (HP) vs. HP + continuous veno-venous hemofiltration (CVVH) for acute Paraquat (PQ) poisoning.
  
  
  METHODS
  This was a multicenter retrospective study of patients with PQ poisoning between January 2013 and June 2014. Clinical data and PQ serum levels were collected at baseline and after 24, 48, and 72 h of treatment.
  
  
  RESULTS
  Seventy-five, 65, and 43 underwent conservative treatment only (conservative treatment group), conservative treatment + HP (HP group), and conservative treatment + HP + CVVH (HP + CVVH group), respectively. PQ serum levels decreased in all groups after 72 h of treatment (p < 0.001); meanwhile, these values decreased faster in the HP and HP + CVVH groups compared with the conservative treatment group. More importantly, PQ blood levels were significantly lower in the HP + CVVH group compared with the HP group at 24 h (p < 0.05). Sequential organ failure assessment (ΔSOFA) values in the HP and HP + CVVH groups were significantly lower compared with that obtained for the conservative treatment group (p < 0.05). The 60-day survival rates were 21.3, 43.1 and 46.5%, respectively. Multivariate analysis indicated that age, PQ dose, admission PQ levels, and admission SOFA score were independently associated with mortality. HP and HP + CVVH were protective factors.
  
  
  CONCLUSIONS
  Early HP or HP + CVVH after PQ poisoning could decrease PQ blood levels, alleviate organ damage, and increase survival.
authors.affiliation: Department of Occupational Diseases and Poisoning Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
authors.forename: An
authors.initials: A
authors.lastname: Li
authors.forename: Wenxiong
authors.initials: W
authors.lastname: Li
authors.forename: Fengtong
authors.initials: F
authors.lastname: Hao
authors.forename: Haishi
authors.initials: H
authors.lastname: Wang
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006440:Hemofiltration; D006464:Hemoperfusion; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010269:Paraquat / Q000097:blood / Q000506:poisoning*; D011041:Poisoning / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention; D015996:Survival Rate; D013997:Time Factors
chemical_list: D010269:Paraquat