Evaluation of gastric lavage effi ciency and utility using a rapid quantitative method in a swine paraquat poisoning model
10.5847/wjem.j.1920-8642.2020.03.008
- Author:
Yun-fei Jiang
- Publication Type:Journal Article
- Keywords:
Acute paraquat poisoning;
Gastric lavage;
Sodium dithionite test;
Swine model
- From:
World Journal of Emergency Medicine
2020;11(3):174-181
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: Gastric lavage (GL) is one of the most critical early therapies for acute paraquat
(PQ) poisoning; however, details of the treatment protocol remain to be established.
METHODS: A rapid quantitative method involving sodium dithionite testing was developed.
It was validated for the determination of the PQ concentrations in gastric juice and eluate samples
from a swine acute PQ poisoning model with early or delay GL, or without. The vital signs, laboratory
testing, and PQ plasma concentrations were collected for therapeutic effect evaluation.
RESULTS: The reaction conditions of the test were optimized for two types of samples. Early
GL at one hour (H1) could improve the signs and symptoms after acute PQ poisoning at 24 hours
(H24). In contrast, GL at 6 hours (H6) could only partially relieve the vital signs. The H1 GL group
effectively reduced the peak of the plasma PQ concentration. In addition, the PQ concentrations in
the plasma and the gastric juice were signifi cantly decreased in both the GL groups as compared to
the untreated group at H24. Moreover, there was no signifi cant difference in the washing effi ciencies
calculated from the total eluates between the two GL groups. However, the washing effi ciency of the
fi rst 10 L eluate is superior to that of the additional 10 L eluate.
CONCLUSION: GL only at early stage may it benefit PQ poisoning in an animal model. The
currently used 20 L GL volume may need to be reduced in view of the low washing efficiency in
the later 10 L eluate. The rapid quantitative method can be used for gastric juice sample and has a
certain value for clinical GL practices.