Effects of sequential blood purification on the organ function and lethality in patients with paraquat-induced multiple organ dysfunction syndrome

Fei Xu; Chao Liu; Qiaozhi Zhou; Fei Ma

Effects of sequential blood purification on the organ function and lethality in patients with paraquat-induced multiple organ dysfunction syndrome

Am J Transl Res. 2022 Mar 15;14(3):1818-1825. eCollection 2022.

Authors

Fei Xu¹, Chao Liu¹, Qiaozhi Zhou¹, Fei Ma²

Affiliations

¹ Department of Emergency, 3201 Hospital of Xi'an Jiaotong University Health Science Center Hanzhong 723000, Shaanxi Province, China.
² Department of Emergency, Hanzhong Center Hospital Hanzhong 723000, Shaanxi Province, China.

PMID: 35422907
PMCID: PMC8991169

Abstract

Objective: To explore the efficacy of sequential blood purification in paraquat (PQ) poisoning-induced multiple organ dysfunction syndrome (MODS).

Methods: Forty-six patients with MODS caused by PQ poisoning admitted to our hospital during January 2016-December 2020 were retrospectively enrolled. The patients were allocated into the experimental group (n = 20) and the control group (n = 26) in accordance with the different treatment methods of blood purification. The experimental group was given sequential blood purification, and the control group was given separate blood purification. The two groups were compared in terms of blood biochemical indices, inflammatory factor levels, level of organ injury and treatment efficiency.

Results: The blood biochemical indices and inflammatory factor levels after treatment were noticeably reduced in both groups (P < 0.05), and the experimental group exhibited lower alanine aminotransferase, MB isoenzyme of creatine kinase, creatinine and blood urea nitrogen than the control group at 3 and 5 days after treatment (P < 0.05). The experimental group exhibited remarkably lower aspartate aminotransferase, lactate dehydrogenase, interleukin-6 and tumor necrosis factor-α levels, and noticeably higher interleukin-10 levels than the control group at 5 days after treatment (P < 0.05). After treatment, the experimental group showed remarkably lower overall organ damage rate (10%) than the control group (58.69%). After treatment, the two groups exhibited remarkably lower disease severity than that before treatment (P < 0.05). At 5 days after treatment, the experimental group showed remarkably lower Acute Physiology and Chronic Health Evaluation II score than the control group (P < 0.05). The experimental group showed noticeably shorter duration of mechanical ventilation, length of coma, intensive care unit stay and hospital stay than the control group after treatment (P < 0.05). The experimental group showed a remarkably higher overall efficiency of treatment (90%) than the control group (76.92%).

Conclusion: Compared with blood purification therapy alone, sequential blood purification therapy can improve the indices of liver function and coma status, suppress the inflammatory response, reduce the APACHE II score, and shorten the overall duration of treatment of patients with PQ poisoning-induced MODS.

Keywords: Paraquat; multiple organ dysfunction syndrome; sequential blood purification.