A clinical profile of paraquat poisoning in a tertiary care hospital: a case series

Background: Paraquat is a widely used weedicide in India. It is now being increasingly used as a suicidal poisoning and is almost always fatal as there is no specific antidote for paraquat poison. ARDS, acute kidney injury or multi-organ failure are the frequent causes of mortality. Methods: The study aimed to study the morbidity and mortality rates of Paraquat poisoning in tertiary care hospital. Patients admitted with Paraquat poisoning were included, and the data collected and analysed. Results: The total number of cases admitted with paraquat poisoning in the General Medicine Ward and Intensive Care Unit in nine months duration were 22 out of which 18 were suicidal and 4 were accidental ingestion. 84% of cases died within a week of ingestion. Almost all of them had Acute Kidney Injury and finally succumbed to multi-organ failure. The overall mortality rate was 72% despite best efforts. Higher mortality has been associated with delayed presentation. No correlation was found between higher creatinine values at presentation and outcome. Conclusions: Thus, paraquat poisoning is very serious and life threatening. Inspite of supportive haemodialysis, steroids and cyclophosphamide therapy, antibiotics, it was ineffective in reducing the mortality rates. Hemoperfusion if initiated within 4 hours of ingestion showed a better outcome but none of the patient presented to our side within 4 hour of ingestion. Paraquat is now banned in 32 countries but still poses a major threat as a suicidal agent in India.