Abstract

BackgroundThe success rate of rescue is extremely low in acute paraquat poisoning. This study aimed to assess whether strengthened hemoperfusion (SHP) combined with continuous venovenous hemofiltration (CVVH) improves prognosis in patients with acute paraquat poisoning.MethodsPatients from January 2005 to December 2018 were enrolled retrospectively. All selected patients were administered conventional therapy. They were divided according to the received treatments in the conventional therapy, hemoperfusion (HP), CVVH, SHP and SHP + CVVH groups. Follow-up was implemented until the 90th day after poisoning. Other outcomes included all-cause mortality on the 15th day after poisoning, and the percentages of respiratory failure and mechanical ventilation use.ResultsThe study included 487 patients,and 211 died in all. Mortality rate in the SHP + CVVH group on the 90th day after poisoning was significantly decreased compared with those of other groups (p<0.001). Survival curves of all groups showed significant differences (p<0.001). SHP combined with CVVH was an independent factor reducing mortality risk (p<0.001). Mortality rate in the SHP + CVVH group on the 15th day after poisoning was also significantly decreased (p < 0.05). The proportions of patients in the SHP + CVVH group with acute respiratory failure and mechanical ventilation were significantly lower than those of other groups (p < 0.05).ConclusionsSHP with CVVH may decrease the mortality rate of patients with acute paraquat poisoning on the 90th day after poisoning and improve the prognosis.

Highlights

  • The success rate of rescue is extremely low in acute paraquat poisoning

  • Clinical study on the effect of strengthened hemoperfusion (SHP) combined with continuous venovenous hemofiltration (CVVH) on the prognosis of acute paraquat poisoning has not been reported yet. To address these knowledge deficits, we aimed to investigate whether SHP combined with CVVH improved the prognosis of patients with acute paraquat poisoning

  • Grouping Patients are divided into 5 groups according to different therapies: conventional therapy, hemoperfusion (HP), continuous venovenous hemofiltration (CVVH), strengthened hemoperfusion (SHP), strengthened hemoperfusion combined with continuous venovenous hemofiltration (SHP + CVVH) groups

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Summary

Introduction

This study aimed to assess whether strengthened hemoperfusion (SHP) combined with continuous venovenous hemofiltration (CVVH) improves prognosis in patients with acute paraquat poisoning. The poisonous dose of acute paraquat is low and. And single or discontinuous and repeated hemoperfusion sessions are mostly adopted to treat acute paraquat poisoning in current clinical studies [3,4,5]. CVVH can be used to treat and cure patients with acute paraquat poisoning. According to few singlecenter clinical research studies, the influence of early and single or discontinuous and repeated HP can be combined with CVVH on prognosis of patients with acute paraquat poisoning [4, 9]. HP combined with CVVH might assist in maintaining electrolytes and acid-base balance, and in better removal of inflammation factors, creatinine and urea nitrogen [3]

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