From the Guidelines
Paraquat poisoning requires immediate hospitalization and treatment with caution, particularly with regards to oxygen therapy, which should only be given if the saturation falls below 85% and reduced or stopped if the saturation rises above 88%. This approach is based on the most recent guideline for oxygen use in adults in healthcare and emergency settings 1. The management of paraquat poisoning involves several key strategies:
- Inducing vomiting only if ingestion was recent (within 1 hour) and the person is conscious
- Administering activated charcoal (1g/kg body weight mixed with water) as soon as possible to reduce absorption
- Providing supportive care, including oxygen therapy with careful monitoring of saturation levels, fluid management, and possibly hemodialysis for severe cases
- Considering immunosuppressive therapy with cyclophosphamide and methylprednisolone to prevent lung fibrosis The treatment of poisoning, in general, includes prevention of additional exposure, removal of the poison (when possible), provision of supportive care, and administration of medications that reverse or bypass the effect of the poison on its molecular target (antidotes) 1. In the case of paraquat poisoning, prevention is crucial, and it should be stored securely, handled with protective equipment, and never transferred to unlabeled containers. The mortality rate is high, especially with significant ingestion, and survivors often face long-term lung damage.
From the Research
Paraquet Poisoning Overview
- Paraquat (PQ) poisoning is a life-threatening condition with a high-mortality rate, as seen in a case report and literature review 2.
- The condition can rapidly progress to multiorgan failure, despite aggressive intervention, due to oxidative stress caused by PQ toxicity 2, 3.
Symptoms and Treatment
- Symptoms of paraquat poisoning can range from mild to severe and include vomiting, dizziness, generalized body aches, jaundice, respiratory distress, and PQ-induced tongue ulcers 2, 4.
- Treatment is mainly supportive, focusing on reducing oxidative damage and organ dysfunction, and may include gastric lavage, activated charcoal, corticosteroids, antioxidants, and monitoring of renal and hepatic function 2, 5.
- Hemodialysis, hemoperfusion, and forced diuresis may also be used to eliminate paraquat from the body 5, 6.
Prognosis and Management Challenges
- The most important prognostic indicator is the quantity of paraquat absorbed, as shown by the plasma paraquat concentration 3.
- The absence of caustic burns in the upper digestive tract indicates a good prognosis 3.
- Management of paraquat poisoning is challenging due to the rapid progression of the condition and the limited effectiveness of current therapies 2, 3.
- Public health measures, including stricter regulations and increased awareness regarding PQ's toxicity, are crucial in preventing future cases 2.