Department of Emergency Medicine, the Second Affiliated Hospital of Kunming Medical University, Kunming, China.
BMC Pharmacol Toxicol. 2020 Jul 6;21(1):49. doi: 10.1186/s40360-020-00428-z.
The 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.
Patients 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.
The 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).
SHP with CVVH may decrease the mortality rate of patients with acute paraquat poisoning on the 90th day after poisoning and improve the prognosis.
急性百草枯中毒的抢救成功率极低。本研究旨在评估强化血液灌流（SHP）联合连续性静脉-静脉血液滤过（CVVH）是否能改善急性百草枯中毒患者的预后。
回顾性纳入 2005 年 1 月至 2018 年 12 月的患者。所有入选患者均接受常规治疗。根据常规治疗中接受的治疗方法，将患者分为血液灌流（HP）、CVVH、SHP 和 SHP+CVVH 组。随访至中毒后第 90 天。其他结局包括中毒后第 15 天的全因死亡率，以及呼吸衰竭和机械通气使用率。
共纳入 487 例患者，共有 211 例死亡。中毒后第 90 天 SHP+CVVH 组死亡率明显低于其他组（p<0.001）。各组的生存曲线差异有统计学意义（p<0.001）。SHP 联合 CVVH 是降低死亡率的独立因素（p<0.001）。中毒后第 15 天 SHP+CVVH 组死亡率也明显降低（p<0.05）。SHP+CVVH 组急性呼吸衰竭和机械通气的患者比例明显低于其他组（p<0.05）。
SHP 联合 CVVH 可降低急性百草枯中毒患者中毒后第 90 天的死亡率，改善预后。
