Outcome of Paraquat Poisoned Patients Treated with a Commonly Used Therapeutic Flowchart: A Case Series | ||
| Asia Pacific Journal of Medical Toxicology | ||
| مقاله 3، دوره 4، شماره 4، اسفند 2015، صفحه 139-142 اصل مقاله (501.36 K) | ||
| نوع مقاله: Original Article | ||
| شناسه دیجیتال (DOI): 10.22038/apjmt.2015.6359 | ||
| نویسندگان | ||
| Devanur Rajashekhara Murthy Mahadeshwara Prasad* 1؛ Abhilash Chennabasappa2 | ||
| 1Department of Forensic Medicine and Toxicology, District Hospital and Chamarajanagar Institute of Medical Sciences, Chamarajanagar, Karnataka, India | ||
| 2Shimoga Institute of Medical Science, Shimoga, Karnataka, India | ||
| چکیده | ||
| Background: Paraquat poisoning is a medical emergency challenge due to its inherent severe toxicity and unavailability of specific antidote for it. In this paper, a series of patients who were treated according to a commonly used treatment flowchart are presented. Methods: This prospective observational study was carried out on paraquat poisoned patients admitted to District Hospital, Chamarajanagar and Shimoga institute of Medical Sciences, Shimoga, Karnataka, India, during January 2013 to December 2014. Results: Six patients (4 women and 2 men) with median age of 23 [min-max: 18-42] years were studied. The majority of patients had respiratory distress (with an average SpO2 of 60%), i.e. 4 out of 6 cases manifested with respiratory distress associated with dryness and burning sensation in mouth, throat and chest. Oxygen therapy with mask in one case and by ventilator in rest of cases was required. Except one patient who died on the first day and no further measurement of serum creatinine could be taken from her, all other patients developed increased creatinine. Five out of 6 patients died mainly due to pulmonary sequels. In the only survived patient, gastrointestinal symptoms were predominant followed by acute renal failure and pulmonary congestion which were reverted with medical care indicated in the therapeutic flowchart. In post-mortem investigations, inflammatory infiltration in lungs was noted in all cases and acute tubular necrosis was seen in 3 cases. Conclusion: Renal insufficiency and pulmonary damage following severe paraquat poisoning are indicators of poor prognosis and may not be reversible with commonly used treatment approaches. | ||
| کلیدواژهها | ||
| Clinical Protocols؛ Paraquat؛ Poisoning؛ Renal Insufficiency؛ Respiratory insufficiency | ||
| اصل مقاله | ||
|
How to cite this article: Prasad DRMM, Chennabasappa A. Outcome of Paraquat Poisoned Patients Treated with a Commonly Used Therapeutic Flowchart: A Case Series. Asia Pac J Med Toxicol 2015;4: 139-42. | ||
| مراجع | ||
|
[1]. Denizbaşı A. Zehirlenmiş Hastaya Acil Yaklaşım. In: Kekeç Z, editor. Tüm Yönleriyle Acil Tıp Tanı Tedavi ve Uygulama Kitabı. 2. Baskı. Adana: Nobel Kitabevi; 2011.p.421-430.
[2]. Rosner MH. Hemodialysis for the non-nephrologist. South Med J. 2005;98(8):785-91.
[3]. Shadnia S, Esmaily H, Sasanian G, Pajoumand A, Hassanian-Moghaddam H. Pattern of acute poisoning in Tehran-Iran. Hum Exp Toxicol 2007; 26(9): 753-6.
[4]. Satar S, Alpay NR, Sebe A, Gokel Y. Emergency hemodialysis in the management of intoxication. Am J Ther. 2006;13(5):404-10.
[5]. Jha VK, Padmaprakash KV. Extracorporeal Treatment in the Management of Acute Poisoning: What an Intensivist Should Know? Indian J Crit Care Med. 2018;22(12):862-869.
[6]. Schreiner GE. The Role of Hemodialysis (Artificial Kidney) in Acute Poisoning. AMA Arch Intern Med. 1958;102(6):896–913.
[7]. King JD, Kern MH, Jaar BG. Extracorporeal Removal of Poisons and Toxins. Clin J Am Soc Nephrol. 2019;14(9):1408-1415.
[8]. Güngörer B, Katı C, Köse F. Evaluation of Hemodialysis and Hemoperfusion in Poisoned Patients. Eurasian J Emerg Med. 2019;18(4): 218-22.
[9]. Holubek WJ, Hoffman RS, Goldfarb DS, Nelson LS. Use of hemodialysis and hemoperfusion in poisoned patients, Kidney Int. 2008;74:1327-34.
[10]. Darracq MA, Cantrell FL. Hemodialysis and extracorporeal removal after pediatric and adolescent poisoning reported to a state poison center. J Emerg Med. 2013;44(6):1101-7.
[11]. Thuan L, Ngoc N, Due P. Effectiveness of Continuous Veno-Venous Hemofiltration and Intermittent Hemodialysis in the Treatment of Severe Acute Phenobarbital Poisoning. APJMT, 2013; 2(1): 10-13.
[12]. Zeinali M, Motamed M, Almasi Dooghaee M. A Case Report of Putaminal Hemorrhage Due to Methanol Toxicity; is Hemodialysis the Offender? APJMT, 2021; 10(2): 74-76.
[13]. Park S, Lee S, Park S, Gil H, Lee E, Yang J, et al. Concurrent Hemoperfusion and Hemodialysis in Patients with Acute Pesticide Intoxication. Blood Purif. 2016;42(4):329-336.
[14]. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 34th Annual Report. Clin Toxicol (Phila). 2017;55(10):1072-1252.
[15]. Hassanian-Moghaddam H, Zamani N, Roberts DM, Brent J, McMartin K, Aaron C et al. Consensus statements on the approach to patients in a methanol poisoning outbreak. Clin Toxicol (Phila). 2019;57(12):1129-1136.
[16]. Mowry JB, Spyker DA, Cantilena LR Jr, Bailey JE, Ford M. 2012 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 30th Annual Report. Clin Toxicol (Phila). 2013; 51:949-1229.
[17]. Güngörer B, Katı C, Köse F. Evaluation of Hemodialysis and Hemoperfusion in Poisoned Patients. Eurasian J Emerg Med. 2019;18(4): 218-22.
[18]. El-Sheikh AA, Khayal EE-S, Allam R. Human kidney injury molecule-1 and interleukin-18 as predictive markers of nephrotoxicity in acute organophosphorus poisoned patients in Zagazig University hospitals. J Toxicol Environ Health Sci. 2018;10 (5):34-43.
| ||
|
آمار تعداد مشاهده مقاله: 1,913 تعداد دریافت فایل اصل مقاله: 1,289 |
||