Hemofiltration and Hemoperfusion for Acute Paraquat Poisoning

Paraquat, an extremely toxic herbicide, is the leading cause of fatal poisoning in much of the developing world, especially Asia, where it is commonly used in intentional poisonings. Both charcoal hemoperfusion and continuous venovenous hemofiltration (CVVH) are thought to improve elimination of paraquat, but no study has tested whether combining the two therapies improves survival.

Researchers enrolled 110 patients with confirmed paraquat poisoning at a single center in Shanghai over a 4-year period. Fifty-one patients were assigned (not randomized) to receive conventional therapy (tap water gastric lavage; activated charcoal; fluids; diuresis; methylprednisolone; antioxidants; dialysis as needed; and charcoal hemoperfusion), and 59 were as…