OBJECTIVETo investigate the different effect of three methods of blood purification for paraquat poisoning patients:hemoperfusion (HP), hemoperfusion combined with hemodialysis (HP + HD), hemoperfusion combined with continuous veno-venous hemofiltration (HP + CVVH).

METHODS72 cases of paraquat poisoning patients were divided into three groups after giving conventional therapy HP group, HP + HD group, HP + CVVH group. Compared the rate of decline concentrations of paraquat in blood, the liver and the kidney damage between before and after blood purification and contrast the mortality in three groups after different method of blood purification.

RESULTSThe rate of decline concentrations of paraquat in blood of the HP + HD group and HP + CVVH group were both significantly greater than the HP group, but this result of HP + HD group has no significant difference compared with HP + CVVH group; Among the three groups of patients after 72 hours, the degree of dysfunction of liver of the HP + HD group and HP + CVVH group were both significantly lower than the HP group, whilely the degree of dysfunction of kidney of the HP + HD group was significantly lower than the HP group and the HP + CVVH group. The survival time of the HP + HD group and the HP + CVVH group were significant linger than the HP group, but the comparison among the three groups had no significant difference in mortality.

CONCLUSIONThree blood purification methods can effectively remove paraquat absorbed into the blood, and the hemoperfusion combined with hemodialysis or continuous veno-venous hemofiltration can effectively reduce the degree of damage of liver and kidney and also can prolong survival time, but did not significantly improve the survival rate of patients.

Hemofiltration ; methods ; Hemoperfusion ; Humans ; Kidney ; Liver ; Paraquat ; blood ; toxicity ; Renal Dialysis ; Survival Rate ; Treatment Outcome

Cell Adhesion ; drug effects ; Cytokines ; blood ; drug effects ; Humans ; Paraquat ; toxicity

OBJECTIVEto develop a high performance liquid chromatography method (HPLC) for the determination of paraquat in rabbit plasma and study its toxicokinetics in rabbits.

METHODStwelve rabbits were randomly divided into 2 groups with giving oral and intravenous administration of paraquat at a single dose of 60 mg/kg and 6 mg/kg respectively. The plasma paraquat concentrations were determined by HPLC and calculated by DAS pharmacokinetics program.

RESULTSthe linear range of paraquat in plasma was 0.05 ∼ 50.00 mg/L (r = 0.9998). The relative recoveries of the assay were 99.41% ∼ 102.32%. The absolute recoveries of the assay were 83.72% ∼ 90.48%. Both the intra-day and inter-day validations were less than 10%. For oral administration, the toxicokinetics parameters of paraquat were as follows: Cmax (14.46 ± 2.35) mg/L, Tmax (1.63 ± 0.31) h, AUC(0-t) (177.61 ± 14.62) mg × h/L, AUC(0-∞) (182.24 ± 14.54) mg × h/L, While for intravenous administration, the toxicokinetics parameters of paraquat: Cmax (35.13 ± 5.53) mg/L, Tmax 0.05 h, AUC(0-t) (121.74 ± 12.30) mg × h/L, AUC(0-∞) (125.12 ± 12.17) mg × h/L, The difference of these parameters between the two groups had statistical significance (P < 0.05). The oral bioavailability was (14.66 ± 1.55)%.

CONCLUSIONthe oral bioavailability of paraquat is relatively low. The biological half life of paraquat is relatively long and there is no significant difference between oral administration and intravenous on biological half life. This method is simple, sensitive and accurate. It can be used for the investigation of paraquat in rabbits.

Administration, Oral ; Animals ; Biological Availability ; Chromatography, High Pressure Liquid ; Injections, Intravenous ; Male ; Paraquat ; blood ; pharmacokinetics ; toxicity ; Rabbits

OBJECTIVETo explore the pathogenesis of paraquat poisoning and observe the change in lipid peroxidation of rats treated with different doses of curcumin.

METHODSA total of 50 8-week-old male Wistar rats (clean grade) were randomly divided into high-dose curcumin plus conventional treatment group, low-dose curcumin plus conventional treatment group, high-dose curcumin treatment group, poisoned group, and blank control group. Glutathione peroxidase (GSH-Px), catalase (CAT), superoxide dismutase (SOD), and malondialdehyde (MDA) levels in rat serum were measured at 1, 3, 7, 14, and 21 d post paraquat injection.

RESULTSCompared with the blank control group, other groups had significantly higher MDA levels but lower SOD, GSH-PX, and CAT activities. The high-dose, low-dose curcumin plus conventional treatment, and high-dose curcumin treatment groups had significantly lower serum lipid peroxidation levels compared with the poisoned group and among them the high-dose curcumin plus conventional treatment group had the most significant improvement.

CONCLUSIONCurcumin can significantly decrease serum lipid peroxidation level in rats and inhibit and delay the occurrence and progression of the damage to the body.

Animals ; Catalase ; blood ; Curcumin ; pharmacology ; Glutathione Peroxidase ; blood ; Lipid Peroxidation ; drug effects ; Male ; Malondialdehyde ; blood ; Paraquat ; toxicity ; Random Allocation ; Rats ; Rats, Wistar ; Superoxide Dismutase ; blood

To identify a prognostic marker that is less sensitive to variations in the elapsed time since paraquat ingestion, we assessed the time between paraquat ingestion and a negative dithionite urine test as a prognostic parameter in patients with acute paraquat intoxication. Forty-one patients with acute paraquat intoxication were enrolled in this study and analyzed to verify significant determinants of mortality and organ dysfunction. The amount of paraquat ingested, paraquat plasma levels, and the time to a negative urine dithionite test were significant independent risk factors predicting mortality. The amount of paraquat ingestion, and the time to a negative urine dithionite test were independent risk factors predicting organ dysfunction. With a cut-off value of 34.5 hr for the time to negative conversion of the urine dithionite test, the sensitivity and specificity for mortality were 71.4% and 75.0%, respectively. The incidence of acute kidney injury and respiratory failure above 34.5 hr were 100% and 85.0%, respectively. In conclusion, the time to a negative urine dithionite test is the reliable marker for predicting mortality and/or essential organ failure in patients with acute paraquat intoxication, who survive 72 hr.
Acute Kidney Injury/etiology/mortality ; Adult ; Aged ; Dithionite/*urine ; Female ; Herbicides/blood/*toxicity ; Humans ; Liver Diseases/etiology/mortality ; Male ; Middle Aged ; Paraquat/blood/*toxicity ; Respiratory Insufficiency/etiology/mortality ; Risk Factors ; Time Factors

OBJECTIVETo observe the best dose of methylprednisolone improving lung injury in swine with paraquat intoxication.

METHODSAcute lung injury (ALI/ARDS) model was made by an intraperitoneal injection of a large dose of 20%PQ solution20 millilitres in swine. Then 24 swine were randomly divided into 4 groups: exposed PQ control group, 5 mg/kg of methylprednisolone group, 15 mg/kg of methylprednisolone group, 30 mg/kg of methylprednisolone group. All groups were based on the conventional rehydration for intervention, Arterial blood samples were collected before modeling and 0, 12, 24, 36 hours after different processing for blood gas analysis. At the same time heart rate (HR), mean arterial pressure (MAP), extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI) were measured by using PICCO (pulse indicator continuous cardiac output), lung tissue was obtained by punctureneedle to produce lung biopsy, then observe the pathological changes of lung tissue in the microscope.

RESULTS1. Comparison between groups: there is no significant difference about extravascular lung water index (EVLWI) and semi-quantitative score of lung tissue pathology in four groups (P > 0.05) before modeling, so is t0, there is significant difference at about extravascular lung water index and semi-quantitative score of lung tissue pathology 12 h, 24 h and 36 h after different processing (P < 0.05). Within the group: EVLWI and semi-quantitative score of Lung tissue pathology in four groups significantly increased when the model was made (P < 0.05), after different processing, EVLWI and semi-quantitative score of Lung tissue pathology in exposed PQ control group kept going up, in other three groups, EVLWI and semi-quantitative score of lung tissue pathology went down first and then went up, there is significant difference compared with t0 (P < 0.05). 2. Comparison between groups: there is no significant difference about oxygenation index in four groups (P > 0.05) before modeling, so is t0, there is significant difference about oxygenation at 12 h, 24 h and 36 h after different processing (P < 0.05). Within the group: oxygenation index in four groups significantly decreased when the model was made (P < 0.05), after different processing, oxygenation index in exposed PQ control group kept going down, in other three groups, it showed a downward trend after the first rise, there is significant difference compared with t0 (P < 0.05). 3. After medication for 36h, correlation analysis showed that EVLWI were negatively associated with oxygenation index (r = -0.427, P = 0.022) and positively associated with semi-quantitative score of Lung tissue pathology (r = 0.903, P = 0.034).

CONCLUSIONMethylprednisolone can obviously relieve lung injury caused by paraquat poisoning and improve oxygenation. After the model was made, within 24 hours, 30 mg/kg of methylprednisolone have advantage for the PQ poisoning swine, but 15mg/kg of methylprednisolone is best for improving lung injury induced by paraquat intoxication within 24 hours to 36 hours.

Acute Lung Injury ; chemically induced ; drug therapy ; Animals ; Blood Gas Analysis ; Capillary Permeability ; Extravascular Lung Water ; Heart Rate ; Lung ; Lung Injury ; Methylprednisolone ; administration & dosage ; therapeutic use ; Paraquat ; toxicity ; Swine