(1351) Prognostic Comparison of Goal-Oriented and Routine Hemoperfusion for Diquat Poisoning

Introduction: Since paraquat was banned in China, Diquat has become a widely used herbicide in agriculture. The lethal dose of paraquat with a concentration of 20% ranges from 5 to 15 ml. Diquat is an herbicide widely used in agricultural production in other developing countries, which has the characteristics of quick effect and low environmental residue; It is also one of the most common causes of pesticide poisoning in China. Diquat is highly toxic to humans, and has no specific antidote. The lethal dose range of Diquat with an oral concentration of 20% is 6-12g (30-60ml), which is fatal.

Methods: This prospective observational study involved patients with acute diquat poisoning admitted from March 2019 to September 2021. The patients received either goal-oriented or routine HP. All other treatments were the same between the two groups. The primary endpoint was 28-day mortality after poisoning. The secondary endpoints were the incidence of organ dysfunction within 7 days and 7-day mortality.

Results: Seventy-eight patients were enrolled (45 in the control group and 33 in the goal-oriented group). The two groups were similar in terms of clinical characteristics. There was no significant difference in the incidence of organ dysfunction between the two groups within 1 week of admission. Mortality on day 7 was significantly lower in the goal-oriented than control group, but there was no difference on day 28. However, 28-day mortality was significantly lower in the goal-oriented group among patients with an oral dose of ≤60 ml.

Conclusions: HP with monitoring of the urine diquat concentration as goal-oriented therapy can reduce the early mortality of diquat poisoning. For patients with oral dosage ≤ 60 ml, the 28-day risk of death was reduced.