Prediction of outcome following paraquat poisoning by arterial lactate concentration‑time data

Sun,Liang; Li,Guo‑Qiang; Yan,Peng‑Bo; Liu,Yang; Li,Guo‑Feng; Wei,Lu‑Qing

doi:10.3892/etm.2014.1773

Prediction of outcome following paraquat poisoning by arterial lactate concentration‑time data

Authors:
- Liang Sun
- Guo‑Qiang Li
- Peng‑Bo Yan
- Yang Liu
- Guo‑Feng Li
- Lu‑Qing Wei
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Affiliations: Department of Respiratory and Critical Care Medicine, Pingjin Hospital, Logistics University of the Chinese People's Armed Police Forces, Tianjin 300162, P.R. China
Published online on: June 11, 2014 https://doi.org/10.3892/etm.2014.1773
Pages: 652-656

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Abstract

The present study retrospectively analyzed 170 patients diagnosed with paraquat (PQ) poisoning with the aim of clarifying whether the arterial lactate‑time (arterial lactate concentration x time between ingestion and arterial lactate measurement) was a good predictor of mortality in patients with acute PQ poisoning. The results indicated that there was a positive correlation between the arterial lactate‑time and PQ concentration‑time (ρ=0.485). In addition, the arterial lactate‑time data exhibited a similar discriminative power to the plasma PQ concentration‑time data (z=0.712; P=0.864). For the receiver operating characteristic curve analysis, the lactate‑time data had an area of 0.782 with a cut‑off value of 11.95 mmol/l.h (sensitivity, 64.52%; specificity, 84.42%). To calculate the predicted probability of survival for any specified time and initial arterial lactate concentration, the following formula was derived based on the logistic regression coefficients: Logit(p) = 3.066 ‑ 0.139 x (time lag following PQ ingestion) ‑ 0.177 x (initial arterial lactate concentration); where the probability of survivors = 1/1 + e‑logit(p). Therefore, the arterial lactate‑time data exhibited a good predictive power for evaluating the prognosis of patients with acute PQ poisoning.

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1	Jones AL, Elton R and Flanagan R: Multiple logistic regression analysis of plasma paraquat concentrations as a predictor of outcome in 375 cases of paraquat poisoning. QJM. 92:573–578. 1999. View Article : Google Scholar : PubMed/NCBI
2	Rebello G and Mason JK: Pulmonary histological appearances in fatal paraquat poisoning. Histopathology. 2:53–66. 1978. View Article : Google Scholar : PubMed/NCBI
3	Lin JL, Lin-Tan DT, Chen KH, et al: Improved survival in severe paraquat poisoning with repeated pulse therapy of cyclophosphamide and steroids. Intensive Care Med. 37:1006–1013. 2011. View Article : Google Scholar : PubMed/NCBI
4	Addo E and Poon-King T: Leucocyte suppression in treatment of 72 patients with paraquat poisoning. Lancet. 1:1117–1120. 1986. View Article : Google Scholar : PubMed/NCBI
5	Shi Y, Bai Y, Zou Y, et al: The value of plasma paraquat concentration in predicting therapeutic effects of haemoperfusion in patients with acute paraquat poisoning. PLoS One. 7:e409112012. View Article : Google Scholar : PubMed/NCBI
6	Matthew H, Logan A, Woodruff MF and Heard B: Paraquat poisoning - lung transplantation. Br Med J. 3:759–763. 1968. View Article : Google Scholar : PubMed/NCBI
7	Licker M, Schweizer A, Hohn L, Morel DR and Spiliopoulos A: Single lung transplantation for adult respiratory distress syndrome after paraquat poisoning. Thorax. 53:620–621. 1998. View Article : Google Scholar : PubMed/NCBI
8	Senarathna L, Eddleston M, Wilks MF, et al: Prediction of outcome after paraquat poisoning by measurement of the plasma paraquat concentration. QJM. 102:251–259. 2009. View Article : Google Scholar : PubMed/NCBI
9	Proudfoot AT, Stewart MS, Levitt T and Widdop B: Paraquat poisoning: significance of plasma paraquat concentrations. Lancet. 2:330–332. 1979. View Article : Google Scholar : PubMed/NCBI
10	Scherrmann JM, Houze P, Bismuth C and Bourdon R: Prognostic value of plasma and urine paraquat concentration. Hum Toxicol. 6:91–93. 1987. View Article : Google Scholar : PubMed/NCBI
11	Hart TB, Nevitt A and Whitehead A: A new statistical approach to the prognostic significance of plasma paraquat concentrations. Lancet. 2:1222–1223. 1984. View Article : Google Scholar : PubMed/NCBI
12	Gil HW, Kang MS, Yang JO, et al: Association between plasma paraquat level and outcome of paraquat poisoning in 375 paraquat poisoning patients. Clin Toxicol (Phila). 46:515–518. 2008. View Article : Google Scholar : PubMed/NCBI
13	Fock KM: Clinical features and prognosis of paraquat poisoning: a review of 27 cases. Singapore Med J. 28:53–56. 1987.PubMed/NCBI
14	Lee Y, Lee JH, Seong AJ, et al: Arterial lactate as a predictor of mortality in emergency department patients with paraquat intoxication. Clin Toxicol (Phila). 50:52–56. 2012. View Article : Google Scholar : PubMed/NCBI
15	Liu XW, Ma T, Qu B, et al: Prognostic value of initial arterial lactate level and lactate metabolic clearance rate in patients with acute paraquat poisoning. Am J Emerg Med. 31:1230–1235. 2013. View Article : Google Scholar : PubMed/NCBI
16	Posecion NC, Ostrea EM and Bielawski DM: Quantitative determination of paraquat in meconium by sodium borohydride-nickel chloride chemical reduction and gas chromatography/mass spectrometry (GC/MS). J Chromatogr B Analyt Technol Biomed Life Sci. 862:93–99. 2008. View Article : Google Scholar
17	DeLong ER, DeLong DM and Clarke-Pearson DL: Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 44:837–845. 1988. View Article : Google Scholar : PubMed/NCBI
18	Kompanje EJ, Jansen TC, van der Hoven B and Bakker J: The first demonstration of lactic acid in human blood in shock by Johann Joseph Scherer (1814–1869) in January 1843. Intensive Care Med. 33:1967–1971. 2007.PubMed/NCBI
19	Aduen J, Bernstein WK, Khastgir T, et al: The use and clinical importance of a substrate-specific electrode for rapid determination of blood lactate concentrations. JAMA. 272:1678–1685. 1994. View Article : Google Scholar : PubMed/NCBI