Will drinking paraquat cause pulmonary fibrosis?

Now there are several cases of paraquat poisoning every year. Paraquat mostly occurs in rural areas. People do not have a clear understanding of paraquat. They always get poisoned by taking it by mistake. Severe cases can cause harmful problems and even lead to pulmonary fibrosis, which will devour human organs bit by bit, and finally cause organ damage, failure and death. Therefore, we must stay away from paraquat and understand these misunderstandings.

Myth 1 :

Most of the poisoning patients who ingested or came into contact with paraquat came from rural areas. They had unclear understanding of the toxicity of paraquat and mistakenly believed that the herbicide was weakly toxic or had no toxic effects on humans. The lethal dose of paraquat is 20-40 mg/Kg, which means that 5 to 15 ml of a 20% paraquat aqueous solution can kill a person. The lethal dose for children is 2 to 5 ml of 20% paraquat aqueous solution. In this regard, relevant departments should strengthen publicity efforts to let farmers truly understand the toxicity of paraquat to humans. When spraying pesticides, you should also pay attention to protection, wear rubber gloves, masks, and work clothes, otherwise paraquat will enter the body through the skin. Change your clothes after spraying. If the medicine splashes on your skin or eyes, rinse immediately with clean water for 10 to 15 minutes. There have been reports of people dying from poisoning due to failure to take protective measures when spraying paraquat. Be careful to keep paraquat and other pesticides at home properly and lock them in a cabinet. Do not leave them lying around.

Myth 2

It is believed that suicide by oral herbicide is less painful. In fact, "after drinking paraquat, it was so painful." Oral administration of paraquat can cause a burning sensation in the mouth, erosion and ulcers of the oral and esophageal mucosa, nausea, vomiting, abdominal pain, diarrhea, and even vomiting and bloody stools. In severe cases, complications such as gastric perforation and pancreatitis may occur. Some patients experience liver enlargement, jaundice, abnormal liver function, and even liver failure. Patients may experience dizziness and headache, and a few may develop central nervous system symptoms such as hallucinations, fear, convulsions, and coma. Renal injury is the most common symptom, manifested as hematuria, proteinuria, oliguria, elevated blood urea nitrogen and digital X-ray imaging, and in severe cases, acute renal failure may occur. Lung damage is the most prominent and severe, manifested by cough, chest tightness, shortness of breath, cyanosis, and dyspnea; for those who do not ingest large amounts, the course is subacute, with chest tightness and shortness of breath appearing in about a week, and dyspnea reaching a peak in 2 to 3 weeks, and patients often die of respiratory failure. A small number of patients developed complications such as pneumothorax, mediastinal emphysema, toxic myocarditis, and pericardial hemorrhage.

Myth 3

Improper oxygen therapy. Some medical personnel still lack understanding of the disease or use oxygen therapy improperly. Routine oxygen administration should be avoided in patients with acute paraquat poisoning. Based on the understanding of the toxicological mechanism of paraquat poisoning, it is recommended that PaO2 < 40 mmHg (5.3 kPa) or acute respiratory distress syndrome be used as an indication for oxygen therapy.

Myth 4

Incorrect blood purification treatment method was chosen. Since plasma exchange only clears poisons with a plasma protein binding rate greater than 80% and a distribution volume less than 0.2L/Kg, and paraquat is almost in a free state in plasma, plasma exchange is not recommended. Theoretically, paraquat is a water-soluble, small molecule substance that is more suitable for hemodialysis. However, since paraquat's own renal clearance rate is much greater than the toxic clearance effect of HD, hemodialysis is recommended only for paraquat poisoning patients with combined renal impairment. Although there is a lack of evidence-based medicine for hemoperfusion, there is a basic consensus on its role in clearing paraquat, and hemodialysis should be performed as soon as possible after oral poisoning.