The Treatment of Paraquat Poisoning by Thunbergia Laurifolia Linn - การรักษาผู้ได้รับสารพาราควอทด้วยรางจืด

Abstract

            Paraquat is a widely used herbicide with a good safety record when used properly.  Most cases of paraquat poisoning result from suicidal ingestion.  There is a high mortality rate of 60 - 100 percent associated with it.  Many attempts to reduce mortality have met with varying results and disappointment.  In this study 57 patients with paraquat poisoning were treated by Fullerีs earth, ascorbic acid, corticosteroid, forced diuresis, and boiled water of Thunbergia laurifolia Linn.  The overall mortality was 47.4 percent.  The amount of paraquat ingested was higher in fatal cases. (92.4 SD 13.3 ml vs 17.4  15.4 ml, p = 0.007).  There was no difference in time before treatment between the patients who survived and those who died  (82.5SD 57.1 min. vs 67.7SD 75.7 min, p = 0.43).  The significant predictors for fatality included the amount of paraquat ingested, leukocytosis, hepatitis, acute renal failure, respiratory failure, proteinuria and positive urine paraquat test.  Subgroup analysis revealed that there were 24 patients with moderate to severe paraquat poisoning.  Compared to the control group of Lin, J.L. et al series who had the same level of severity, the mortality rate in this study was lower (37.5% vs. 57.1%).  Therefore it was primarily concluded that using the boiled water of Thunbergia Laurifolia Linn. may be beneficial in treatment of paraquat poisoning and it may help reduce mortality rate, especially in the moderate to severe group.

Key words: paraquat, Thunbergia laurifolia Linn., suicide