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. 2024 Aug;28(8):741-747.
doi: 10.5005/jp-journals-10071-24764. Epub 2024 Jul 31.

A Study of Paraquat Poisoning Presentation, Severity, Management and Outcome in a Tertiary Care Hospital: Is There a Silver Lining in the Dark Clouds?

Priya Goyal  1 , Parshotam L Gautam  2 , Shruti Sharma  2 , Gunchan Paul  2 , Vaibhav Taneja  2 , Aarti Mona  2
Affiliations

A Study of Paraquat Poisoning Presentation, Severity, Management and Outcome in a Tertiary Care Hospital: Is There a Silver Lining in the Dark Clouds?

Priya Goyal et al. Indian J Crit Care Med. 2024 Aug.

Abstract

Introduction: Accidental or intentional ingestion of paraquat leads to many local and systemic effects and the mortality rate is very high. There is limited data from North India and our objectives were to study the spectrum of presentation, treatment given, and its relation with outcome in a tertiary care setting.

Materials and methods: This retrospective observational study was conducted after ethical approval and data regarding demography, clinical features, duration of presentation, organ involvement, renal replacement therapy (RRT), management, and outcome was collected. Statistical analysis was done by calculating mean and standard deviation (SD). Chi-square (χ2) test was applied to categorical variables and the Fisher exact test was used when the expected frequency was less than 5.

Results: The study population consisted of 91 male (84%) and 18 female patients. Out of 109 patients, 13 survived (12%) and 88% had a fatal outcome. Nearly 92% of patients belonged to rural background, and 68% were of younger (<30 years) age group. Age, gender, occupation, and amount taken did not have any significant relation with mortality. Patients having metabolic acidosis (58.7%), altered renal (75.2%), and hepatic function (62.3%) at presentation had a statistically significant relation with mortality. Duration of presentation was significantly lesser in patients who survived (17.26 ± 17.23, median 14 hours vs 80.18 ± 90.07, median 48 hours) compared to patients who did not survive. Renal replacement therapy (n = 57) had no relation with mortality whereas 36% of the patients who received hemoperfusion (HP) survived (p = 0.03).

Conclusion: Treatment should be started early as the duration of the presentation has a significant association with the outcome. Currently there is no antidote available. Supportive treatment includes oxygenation, immunosuppression, antioxidants, RRT, and HP wherever the resources are available.

How to cite this article: Goyal P, Gautam PL, Sharma S, Paul G, Taneja V, Mona A. A Study of Paraquat Poisoning Presentation, Severity, Management and Outcome in a Tertiary Care Hospital: Is There a Silver Lining in the Dark Clouds? Indian J Crit Care Med 2024;28(8):741-747.

Keywords: Hemoperfusion; Immunosuppression; Mortality; Paraquat; Poisoning; Renal failure.

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Conflict of interest statement

Source of support: Nil Conflict of interest: NoneConflict of interest: None

Figures

Fig. 1
Fig. 1
Distribution of patient population with respect to survival
Fig. 2
Fig. 2
Geographic distribution of patient population
Fig. 3
Fig. 3
Distribution of patients with respect to occupation
Fig. 4
Fig. 4
Relation between time lag to presentation to hospital and outcome
Fig. 5
Fig. 5
Distribution of clinical features and presenting symptoms
Fig. 6
Fig. 6
Relationship between renal replacement therapy and outcome
See this image and copyright information in PMC

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