Leveraging plasma concentrations to optimize extracorporeal treatment in acute diquat poisoning: a multi-center retrospective cohort study

作者：Yuewei Ling, Zhengsheng Mao, Chuhan Zhou, Jinquan Li, Wen Liu, Huazhong Zhang, Lili Jiang, Shinan Nie, Hongmei Zhao, Chao Wu, Jianjun Chen, Yifei Chen, Ge Bai, Jianing Xu, Ping Geng, Chunyang Xu, Jian Huang, Feng Chen, Jinsong Zhang, Hao Sun · 发表于：Clinical Toxicology · 年份：2025 · DOI：10.1080/15563650.2025.2591798 · 被引用次数：2 · 研究领域：Paraquat toxicity studies and treatments、Poisoning and overdose treatments、Drug-Induced Hepatotoxicity and Protection

INTRODUCTION: Diquat poisoning is common in Asia and the optimal enhanced elimination strategy is unknown. This study aimed to evaluate the clinical value of plasma diquat concentrations in guiding personalized extracorporeal treatment regimens for patients with acute diquat poisoning. METHODS: This multi-center retrospective cohort study included 163 patients with acute diquat poisoning admitted between February 2022 and July 2023. Patients were divided into three groups based on plasma diquat concentrations measured upon presentation to the emergency department: low (<100 μg/L), medium (100-1,000 μg/L), and high (≥1,000 μg/L). The evaluated extracorporeal treatment regimens included hemoperfusion alone and a combination of hemoperfusion with continuous veno-venous hemodiafiltration. Kaplan-Meier survival curves were used to estimate cumulative survival probabilities, with survival probabilities compared using log-rank tests. RESULTS: All 66 patients survived in the low concentration group, regardless of the extracorporeal treatment used. In the medium and high concentration groups, five patients who refused extracorporeal treatment died, whereas 92 patients who received extracorporeal treatment had a case fatality rate of 48.9%. In the high concentration group, patients receiving hemoperfusion combined with continuous veno-venous hemodiafiltration had a case fatality rate of 76.7% and better survival probabilities, compared to hemoperfusion-only patients, which had no survi...