• Logo
  • SBMUJournals

Case Report: Hemoperfusion Efficiency in Paraquat Toxicity

Ali Ostadi, Maryam Paeezi




The present study was conducted on paraquat poisoning cases, from January 2017 to January 2018, a total of 9 patients of paraquat poisoning transferred to our referral Toxicology center. Six of them survived. Paraquat is one of the most used herbicides, a non-selective, killing green plants on contact. It is very toxic for human. We used immunosuppressant and antioxidant drugs in most cases.  In addition, many patients were given gastrointestinal decontamination and activated charcoal at a local hospital before transferring to our center. According to our treatments, early management and hemoperfusion after ingestion can increase the rate of survival.


Paraquat, Activated charcoal, N-Acetylsycteine, Hemoperfusion


Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, ADQI workgroup. Acute renal failure-definition, outcome measures, animal models, fluid therapy and information technology needs the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004; 8(4):204-12R. [DOI:10.1186/cc2872] [PMID]

Yang TS, Chang YL, Yen CK. Hemoperfusion treatment in pigs experimentally intoxicated by paraquat. Human & Experimental Toxicology. 1997; 16(12):709-15. [DOI:10.1177/096032719701601203] [PMID]

Suzuki K, Takasu N, Okabe T, Ishimatsu S, Ueda A, Tanaka Sh, et al. Effect of aggressive hemoperfusion on the clinical course of patients with paraquat poisoning. Human & Experimental Toxicology. 1993; 12(4):323-27. [DOI:10.1177/096032719301200411] [PMID]

Hawksworth GH, Bennett PN, Davies DS. Kinetics of paraquat elimination in the dog. Toxicology and Applied Pharmacology. 1981; 57(2):139-45. [DOI:10.1016/0041-008X(81)90273-8]

Li H, Song L, Jian X. Efficacy of hemoperfusion therapy in patients with paraquat poisoning: A meta-analysis. International Journal of Clinical Experimental Medicine. 2017; 10(8):11371-81.

Thuan LQ. Comparing the effectiveness of activated charcoal and resin hemoperfusion on the treatment of acute paraquat poisoning. Paper presented at: 2015 ACMT Scientific Annual Meeting. 27-29 March 2015; Mandalay, Myanmar.

Benson BE, Hoppu K, Troutman WG, Bedry R, Erdman A, Höjer J, et al. Position paper update: Gastric lavage for gastrointestinal decontamination. Clinical Toxicology. 2013; 51(3):140-6. [DOI:10.3109/15563650.2013.770154] [PMID]

Narendra SS, Vinaykumar S. Paraquat poisoning: A case series in south India. International Journal of Science and Research. 2013:2319-7064.

Batman NT, Leach RM. Acute oxygen therapy. Leading General Medical Journal. 1998; 317:798. [DOI:10.1136/bmj.317.7161.798]

Hoet PH, Demedts M, Nemery B. Effects of oxygen pressure and medium volume on the toxicity of paraquat in rat and human type 2 pneumocytes. Human & Experimental Toxicology. 1997; 16(6):305-10. [DOI:10.1177/096032719701600602] [PMID]

Wong OF, Fung Ht, Kam Cw. Case series of paraquat poisoning in tuen mun hospital. Hong Kong Journal of Emergency Medicine. 2006; 13(3):155-60. [DOI:10.1177/102490790601300305]

Lin JL, Leu ML, Liu YC, Chen GH. A prospective clinical trial of pulse therapy with glucocorticoid and cyclophosphamide in moderate to severe paraquat-poisoned patients. American Journal of Respiratory and Critical Care Medicine. 1999; 159(2):357-60. [DOI:10.1164/ajrccm.159.2.9803089].

Perriëns JH, Benimadho S, Kiauw IL, Wisse J, Chee H. High dose cyclophosphamide and dexamethasone in paraquat poisoning. Human & Experimental Toxicology. 1992; 11(2):129-34. [DOI:10.1177/096032719201100212] [PMID]

Roberts DM, Wilks MF, Roberts MS, Swaminathan R, Mohamed F, Dawson AH, et al. Changes in the concentrations of creatinine, cyctatin C and NGAL in patients with acute paraquat self-poisoning. Toxicology Letters. 2011; 202(1):69-74. [DOI:10.1016/j.toxlet.2011.01.024] [PMID] [PMCID]

Koo JR, Kim JC, Yoon JW, Kim GH, Jeon RW, Kim HJ, et al. Failure of continuous venovenous hemofiltration to prevent death in paraquat poisoning. American Journal of Kidney Diseases. 2002; 39(1):55-9. [DOI:10.1053/ajkd.2002.29880] [PMID]

Hsu CW, Lin JL, Lin-Tan DT, Chen KH, Yen TH, Wu MS, et al. Early hemoperfusion may improve survival of severely paraquat-poisoned patients. PLOS One. 2012; 7(10):e48397. [DOI: 10.1371/journal.pone.0048397].

Pond SM, Rivory LP, Hampson EC, Roberts MS. Kinetics of toxic doses of paraquat and the effects of hemoperfusion in the dog. Journal of Toxicology: Clinical Toxicology. 1993; 31(2):229-46. [DOI:10.3109/15563659309000391] [PMID]

Wang HR, Pan J, Shang AD, Lu YQ. Time-dependent hemoperfusion after acute paraquat poisoning. Scientific Reports. 2017; 7(1):2239.

Hampson EC, Effeney DJ, Pond SM. Efficacy of single or repeated hemoperfusion in a canine model of paraquat poisoning. Journal of Pharmacology and Experimental Therapeutics. 1990; 254(2):732-40. [PMID]

Gawarammana IB, Buckley NA. Medical management of paraquat ingestion. British Journal of Clinical Pharmacology. 2011; 72(5):745-57. [DOI:10.1111/j.1365-2125.2011.04026.x] [PMID] [PMCID]

DOI: https://doi.org/10.22037/ijmtfm.v8i4(Autumn).23089