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Intoxicação por Paraquat – experiência de 18 anos de um Serviço de Medicina

dc.contributor.authorSimões, M
dc.contributor.authorAlves, P
dc.contributor.authorEsperto, H
dc.contributor.authorCanha, C
dc.contributor.authorMeira, E
dc.contributor.authorFerreira, E
dc.contributor.authorGomes, M
dc.contributor.authorNascimento-Costa, JM
dc.date.accessioned2013-06-18T13:58:22Z
dc.date.available2013-06-18T13:58:22Z
dc.date.issued2012
dc.description.abstractIntroduction: Paraquat is a contact herbicide commercially available since 1962. Paraquat intoxication (PI) is usually voluntary and highly lethal, since there is no effective antidote. Toxicity occurs through cyclic redox reactions, damaging mainly the kidneys and lungs. Aim, material and methods: featuring the clinical presentation, management and outcome of patients with PI over an 18 years period (from the 01st January 1993 to the 31st December 2010) through the retrospective analysis of clinical files and comparing the survivors and the deceased. Results: Thirty-one cases of Paraquat intoxication were included, with a male: female ratio 1:1. Age range from 13 to 80 years, mean age 42.4years (±18.7).All intoxications were voluntary and by oral route. There was statistical difference in the amount ingested (22.1 mL vs. 72.7 mL, p<0.0005). A non-significant trend to a longer delay until getting medical attention in the deceased group (1.6 h vs. 3.2 h, p=0.091). Statistical significance was found between mortality and leukocytosis, hypocapnea, hypoxemia, LDH, alkaline phosphatase and AST. There was no difference between groups according to treatment options, although hemocarboperfusion was used more often in the deceased group (53.9% vs. 66.7%, p=0.471) and corticosteroids in the survivor group (61.5% vs. 44.4%, p=0.350). Mortality rate was 58.1% (66.7% in the first 72 hours), due to respiratory insufficiency and multiple organ failure. Variable levels of pulmonary fibrosis occurred in 38.5% of the survivors. Discussion & Conclusion: Paraquat intoxication has a poor prognosis with limited efficiency of treatment approaches. The relation between Paraquat in the urine and the time elapsed after ingestion is the main determinant factor in the prognosis. In this study the presence of dyspnea, hypocapnea and hypoxemia was linked to a bad prognosis. There was no statistical difference between the available treatment options.por
dc.identifier.citationMed Int. 2012;19(2):69-73por
dc.identifier.urihttp://hdl.handle.net/10400.4/1561
dc.language.isoporpor
dc.peerreviewedyespor
dc.publisherSociedade Portuguesa de Medicina Internapor
dc.subjectIntoxicaçãopor
dc.subjectParaquatopor
dc.titleIntoxicação por Paraquat – experiência de 18 anos de um Serviço de Medicinapor
dc.title.alternativeParaquat Intoxication – experience of an Internal Medicine ward for 18 yearspor
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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