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World Journal of Emergency Medicine ›› 2020, Vol. 11 ›› Issue (3): 174-181.doi: 10.5847/wjem.j.1920-8642.2020.03.008

Special Issue: Poisoning

• Original Articles • Previous Articles     Next Articles

Evaluation of gastric lavage efficiency and utility using a rapid quantitative method in a swine paraquat poisoning model

Yun-fei Jiang1,2, Jian Kang1, Pei-pei Huang1, Jia-xi Yao3, Zhong-he Wang3, Lei Jiang1, Jun Wang4, Li Qiao1, Bao-li Zhu5, Hao Sun1(), Jin-song Zhang1()   

  1. 1 Department of Emergency, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
    2 Department of Emergency, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
    3 Key Lab of Modern Toxicology, Ministry of Education and Department of Hygienic Analysis and Detection, School of Public Health, Nanjing Medical University, Nanjing, China
    4 Key Lab of Modern Toxicology, Ministry of Education and Department of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, China
    5 Department of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
  • Received:2019-08-20 Accepted:2020-02-26 Online:2020-07-01 Published:2020-07-01
  • Contact: Hao Sun,Jin-song Zhang E-mail:haosun@njmu.edu.cn;zhangjso@njmu.edu.cn

Abstract:

BACKGROUND: Gastric lavage (GL) is one of the most critical early therapies for acute paraquat (PQ) poisoning; however, details of the treatment protocol remain to be established.

METHODS: A rapid quantitative method involving sodium dithionite testing was developed. It was validated for the determination of the PQ concentrations in gastric juice and eluate samples from a swine acute PQ poisoning model with early or delay GL, or without. The vital signs, laboratory testing, and PQ plasma concentrations were collected for therapeutic effect evaluation.

RESULTS: The reaction conditions of the test were optimized for two types of samples. Early GL at one hour (H1) could improve the signs and symptoms after acute PQ poisoning at 24 hours (H24). In contrast, GL at 6 hours (H6) could only partially relieve the vital signs. The H1 GL group effectively reduced the peak of the plasma PQ concentration. In addition, the PQ concentrations in the plasma and the gastric juice were significantly decreased in both the GL groups as compared to the untreated group at H24. Moreover, there was no significant difference in the washing efficiencies calculated from the total eluates between the two GL groups. However, the washing efficiency of the first 10 L eluate is superior to that of the additional 10 L eluate.

CONCLUSION: GL only at an early stage may it benefit PQ poisoning in an animal model. The currently used 20 L GL volume may need to be reduced in view of the low washing efficiency in the later 10 L eluate. The rapid quantitative method can be used for gastric juice samples and has a certain value for clinical GL practices.

Key words: Acute paraquat poisoning, Gastric lavage, Sodium dithionite test, Swine model