Goyal Priya, Gautam Parshotam L, Sharma Shruti, Paul Gunchan, Taneja Vaibhav, Mona Aarti
Department of Anaesthesia, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
Department of Critical Care Medicine, Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
Indian J Crit Care Med. 2024 Aug;28(8):741-747. doi: 10.5005/jp-journals-10071-24764. Epub 2024 Jul 31.
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.
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 (χ) test was applied to categorical variables and the Fisher exact test was used when the expected frequency was less than 5.
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 ( = 57) had no relation with mortality whereas 36% of the patients who received hemoperfusion (HP) survived ( = 0.03).
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.
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.
意外或故意摄入百草枯会导致多种局部和全身影响，死亡率很高。印度北部的数据有限，我们的目的是在三级医疗环境中研究其临床表现谱、所给予的治疗及其与预后的关系。
本回顾性观察研究在获得伦理批准后进行，收集了有关人口统计学、临床特征、就诊时间、器官受累情况、肾脏替代治疗（RRT）、治疗和预后的数据。通过计算均值和标准差（SD）进行统计分析。对分类变量应用卡方（χ）检验，当预期频数小于5时使用Fisher精确检验。
研究人群包括91名男性（84%）和18名女性患者。在109名患者中，13名存活（12%），88%有致命结局。近92%的患者来自农村，68%为年轻（<30岁）年龄组。年龄、性别、职业和摄入量与死亡率无显著关系。就诊时出现代谢性酸中毒（58.7%）、肾功能改变（75.2%）和肝功能改变（62.3%）的患者与死亡率有统计学显著关系。存活患者的就诊时间（17.26±17.23，中位数14小时）明显短于未存活患者（80.18±90.07，中位数48小时）。肾脏替代治疗（n = 57）与死亡率无关，而接受血液灌流（HP）的患者中有36%存活（P = 0.03）。
由于就诊时间与预后有显著关联，应尽早开始治疗。目前尚无解毒剂。支持性治疗包括在资源可用时进行氧疗、免疫抑制、抗氧化剂、肾脏替代治疗和血液灌流。
戈亚尔P，高塔姆PL，夏尔马S，保罗G，塔内贾V，莫娜A。三级医院中百草枯中毒的表现、严重程度、治疗及预后研究：乌云中是否有一线希望？《印度危重症医学杂志》2024；28（8）：741 - 747。
