title: Golden Hours in Severe Paraquat Poisoning-The Role of Early Haemoperfusion Therapy.
abstract: BACKGROUND
  Paraquat is a commonly ingested poison especially in Southern India. There is no antidote for paraquat poison and consumption is often fatal. The usual cause of death is either acute lung injury or multi-organ failure.
  
  
  OBJECTIVE
  To evaluate the role of early haemoperfusion as a therapy in paraquat poisoned patients.
  
  
  METHODS
  This study was a retrospective analysis of patients admitted to a Tertiary Medical College Hospital between January 2012 and December 2015 with history of paraquat consumption, comparing outcomes in those who received only gastric lavage and symptomatic treatment with those who received haemoperfusion as a therapy. The role of early haemoperfusion (≤ 6 hours) vs late haemoperfusion (> 6 hours) in paraquat poisoned patients was also compared. The data of these patients was extracted and analysed with respect to age, sex, mode of treatment, the outcome in patients who received early and late haemoperfusion.
  
  
  RESULTS
  A total of 101 patients were studied out of which 62 died. Deaths were more in those patients who received only gastric lavage with symptomatic treatment as therapy compared to those who received haemoperfusion i.e., 92.1% vs 42.9% respectively. We also found that, the survival rate was better in patients who received early haemoperfusion.
  
  
  CONCLUSIONS
  Early haemoperfusion was helpful in the management of severe paraquat poisoning and improved the survival rate in these patients.
authors.affiliation: Assistant Professor, Department of Medicine, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Raghavendra
authors.initials: R
authors.lastname: Rao
authors.affiliation: Professor, Department of Medicine, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Rama
authors.initials: R
authors.lastname: Bhat
authors.affiliation: Student, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal University , Manipal, Karnataka, India .
authors.forename: Swathi
authors.initials: S
authors.lastname: Pathadka
authors.affiliation: Post Graduate, Department of Community Medicine, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Sravan Kumar
authors.initials: SK
authors.lastname: Chenji
authors.affiliation: Senior Resident, Department of Medicine, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .
authors.forename: Savio
authors.initials: S
authors.lastname: Dsouza
keywords: Acute lung injury; Detoxification; Extracorporeal; Herbicide; Toxicological