Abstract
Changhua is the centre of a large agricultural area in central Taiwan. The first case of paraquat poisoning was seen in 1977, and, since then, the numbers have increased yearly to a total of more than 600 patients. Some interesting cases are presented, including a series of 9 patients who were pregnant at the time of ingestion. Data from amniotic fluid, fetal and cord blood indicates that paraquat crosses the placenta and is concentrated to levels 4-5 times that of maternal blood. Some controversial new modalities of treatment have been investigated. Low-dose radiotherapy has been tried in 9 patients, with 3 survivors. "Continuous hemoperfusion" has been modified, used clinically in over 100 patients, and supplemented by in vitro experiments related to the adsorptive ability for paraquat of DHP-1 columns of activated charcoal. Hypoxic atmospheres have been used in patients as a routine, and continued during anesthesia in selected cases (pregnant and pediatric patients). These changes have resulted in an increase in our survival blood levels from 0.68μg/ml five years ago to 8.9μg/ml this year.
