Role of CVVH in Patients With Acute Paraquat Poisoning
Condition: Poisoning by Paraquat With Undetermined Intent
MeSH terms: Poisoning
Study type: Observational

Summary: 
      Paraquat poisoning is characterized by multiple organ failure and pulmonary fibrosis with
      respiratory failure. Accumulating evidence suggested that continuous venovenous
      hemofiltration (CVVH) had a beneficial role in the treatment of multiple organ dysfunction.
      The investigators hypothesized that CVVH might restore multiple organ function and reduce the
      high mortality rate of paraquat poisoning. To confirm it, an prospective clinical study would
      be carried out.
    

Detailed description: 
      Paraquat (1,1 '-dimethyl-4,4'-bipyridylium dichloride) is widely used as a herbicide.
      Accidental or intentional ingestion of paraquat is common in many developing countries such
      as China, Sri Lanka and Korea because of easy access. The high mortality rate of paraquat is
      due to its high toxicity and the lack of effective treatments. Thus, the paraquat poisoning
      becomes one of major medical problem in the developing countries.

      Paraquat poisoning is also one of major causes of death among young patients with acute
      poisoning in China. It is characterized by multiple organ failure and pulmonary fibrosis with
      respiratory failure. A growing body of evidence suggested that continuous venovenous
      hemofiltration (CVVH) had a great beneficial role in the treatment of multiple organ
      dysfunctions. We hypothesized that CVVH might reduce the high mortality rate of paraquat
      poisoning via restoring the multiorgan function, such as acute hepatic lesion, acute kidney
      injury, acute lung injury and acute pancreatic injury. We expect to enroll 100 patients from
      our hospital within 1 week after oral intake of paraquat. All patients were divided into
      Group 1 and Group 2. Group 1 were treated with a standardized therapeutic regimen including
      stomach lavage, emergency haemoperfusion and drugs. Group 2 were accepted with standardized
      treatment plus CVVH. The aim of this prospective clinical study was to evaluate the safety
      and efficacy of CVVH for the treatment of patients with paraquat poisoning. The survival
      rate, clinical manifestations and clinical parameters between these two groups were compared.
    

Intervention name(s): CVVH; Standardized therapy regimens
Intervention type(s): Procedure; Procedure
Intervention description(s): Ultrafiltration at 35ml/h/Kg; Standardized therapy regimens included the followings:
Remove all contaminated clothing
Gastric lavage
Receive activated charcoal as quickly as possible
Hemoperfusion with activated charcoal(160g)
Immunosuppression with methylprednisolone
Antioxidants (glutathione,1.2 gram iv twice a day)
Supportive care
Other intervention name(s): continuous renal replacement treatment(CRRT); continuous blood purification(CBP)
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        In-patients with acute paraquat poisoning
      
Biospecimen description: 
      Serum, Plasma, Urine,Dialysate
    
Keywords: acute paraquat poisoning; hemoperfusion; continuous blood purification