A study on Clinical features and management of Paraquat poisoning

Abstract

Introduction: Paraquat is a widely used herbicide and a potent toxin. Ingestion, rather than inhalation, is the typical route of exposure associated with human toxicity. There have been systemic reactions following skin exposure after direct exposure to the skin (soaking of the skin with paraquat) or when the skin integrity has been breached (preexisting skin lesions or burn).Most paraquat deaths result from suicidal intent. Although paraquat ingestion leads to acute gastrointestinal tract necrosis and multiorgan failure, the lung is the target organ for toxicity among those surviving the immediate postingestion period. Material and Methods: This is a retrospective study conducted in the Department of Critical Care at NRI Medical College & General Hospital, Guntur. The study included patients with the ages above 14 years old who were presented to the Emergency Department with paraquat poisoning. This includes patients who were self-admitted or with witness account of paraquat exposure (ingestion, inhalational, mucosal or skin contact). Results: In our study, most of the patients were belongs to 26-35 years 17(48.5) followed by 18-25 years 9 (25.7), 36-45 years 6 (17.1), 46-55 years and more than 56 years were 5.7% and 2.8% respectively. The majority were male (n=29, 82.8%) and female (n=6, 17.1%) were least. The main symptoms and signs of studied patients include nausea (94.2%); vomiting (88.5%); Abdominal pain (91.4%); Paraquat tongue (88.5%), Oliguria (45.7%); Jaundice (37.1%), Respiratory distress (2.8%). For survived and non-survived patients, the Amount of ingested paraquat (mL) the mean ± SDwas 25.6±5.6 ml and 295±28 ml respectively. The difference was statistically significant (P=0.001). Conclusion: It is important to establish the diagnosis early and to pursue aggressive decontamination and prevention of further absorption. Increased awareness of the clinician and availability of the laboratory diagnostic methods will definitely help in successful management of paraquat poisoning. Paraquat poisoning is still a concern in developing countries. It may be useful to educate public health professionals and the general population about the serious consequences of exposure to this toxic agent. Paraquat poisoning is still no cure.