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. 2017 Jul 13;12(7):e0181207.
doi: 10.1371/journal.pone.0181207. eCollection 2017.

Effects of hemoperfusion and continuous renal replacement therapy on patient survival following paraquat poisoning

Yadong Wang  1 , Yao Chen  1 , Lu Mao  1 , Guangju Zhao  1 , Guangliang Hong  1 , Mengfang Li  1 , Bin Wu  1 , Xiaorong Chen  1 , Meng Tan  1 , Na Wang  1 , Zhongqiu Lu  1
Affiliations

Effects of hemoperfusion and continuous renal replacement therapy on patient survival following paraquat poisoning

Yadong Wang et al. PLoS One. .

Abstract

Mortality in patients with paraquat (PQ) poisoning is related to plasma PQ levels. Concentrations lower than 5,000 ng/mL are considered critical but curable. This study assessed the effects of hemoperfusion (HP) and continuous renal replacement therapy (CRRT) on the survival of PQ-poisoned patients with plasma PQ levels below 5,000ng/mL. We analyzed the records of 164 patients with PQ poisoning who were treated at the First Affiliated Hospital of Wenzhou Medical University in China between January 2011 and May 2015. We divided these patients into six sub-groups based on baseline plasma PQ levels and treatment, compared their clinical characteristics, and analyzed their survival rates. Patient sub-groups did not differ in terms of age, sex, time between poisoning and hospital admission, or time to first gavage. Biochemical indicators improved over time in all sub-groups following treatment, and the combined HP and CRRT treatment yielded better results than HP or CRRT alone. Fatality rates in the three treatment sub-groups did not differ among patients with baseline plasma PQ levels of 50-1,000 ng/mL, but in patients with 1,000-5,000 ng/mL levels, the mortality rate was 59.2% (HP treatment group), 48% (CRRT treatment group), and 37.9% (combined treatment group). Mortality rates were higher 10-30 days after hospitalization than in the first 10 days after admission. In the early stages of PQ poisoning, CRRT is effective in reducing patient fatality rates, particularly when combined with HP. Our data could be useful in increasing survival in acute PQ poisoning patients.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Survival time of 83 paraquat-poisoned patients (plasma paraquat levels: 50–1,000 ng/mL).
Fig 2
Fig 2. Comparison of survival curves for three treatments.
Hemoperfusion (HP), continuous renal replacement therapy (CRRT), and combined treatment (HP+CRRT) in patients with plasma paraquat levels between 50 and 1,000 ng/mL. The chi-squared value between HP and CRRT was 1.056; p>0.05. The chi-squared value between HP and HP+CRRT was 1.136; p>0.05.
Fig 3
Fig 3. Survival time of 81 paraquat-poisoned patients (plasma paraquat levels: 1,000–5,000 ng/mL).
Fig 4
Fig 4. Comparison of survival curves for three treatments.
Hemoperfusion (HP), continuous renal replacement therapy (CRRT), and combined treatment (HP+CRRT) in patients with plasma paraquat levels between 1,000 and 5,000 ng/mL. The chi-squared value between HP and CRRT was 1.466; p>0.05. The chi-squared value between HP and HP+CRRT was 2.276; p<0.05.
See this image and copyright information in PMC

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