Essential treatment and nursing for the relatively long-term survivors of paraquat intoxication

Fumiko Mine, Taeko Kozawa, Hiroko Ohashi, Sachiyo Hasegawa, Kyoko Niwa, Kazuyo Urata, Kanae Suzuki
1986 Journal of Japanese Society for Dialysis Therapy  
A 30-year-old woman was admitted to the hospital because of paraquat ingestion. She was in her usual state of good health until an attempt at suicide. Although she complained of a sore throat and general irritability only, her husband prompted her to visit the hospital just after she took 10ml of concentrated paraquat solution. Immediately after forced diuresis with continuous administration of a large volume of electrolyte solution, recurrent intestinal lavage and direct hemoperfusion were
more » ... ormed prospectively because it was supposed that liver, kidney and lung involvement would develop subsequently. Several days after admission, jaundice was noticed, and urine volume was abruptly reduced. Hemodialysis was successfully continued for one week for the treatment of acute renal failure. Liver function impairment and renal insufficiency were ameliorated during the one -week course , but unfortunately on the fifth day, a cloudy opaque shadow appeared on the chest X-ray film, suggesting that one of the most important complications, lung fibrosis, had begun. Paraquat toxicity is considered to be elicited by generation of superoxide radicals and lipid peroxides in the paraquat oxidation/reduction cycle, and lung fibrosis could be accelerated by hyperbaric O2 air. Therefore, FiO2 was maintained carefully as low as possible, keeping the patient's PaO2 at least above 50 Torr. She died on the 21st day because of fatal airway bleeding.
doi:10.4009/jsdt1985.19.693 fatcat:bgnu7utxajf4zpffhhkp5cuave