The Area of Ground Glass Opacities of the Lungs as a Predictive Factor in Acute Paraquat Intoxication

• Published in: Journal of Korean medical science Vol. 24; no. 4; pp. 636 - 640
• Main Authors: Kim, Yung-Tong, Jou, Sung-Shick, Lee, Hae-Sung, Gil, Hyo-Wook, Yang, Jong-Oh, Lee, Eun-Young, Hong, Sae-Yong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.08.2009; 대한의학회
• Subjects: Acute Disease; Adult; Diagnosis, Differential; Female; Herbicides - blood; Herbicides - poisoning; Humans; Lung Injury - chemically induced; Lung Injury - diagnostic imaging; Lung Injury - mortality; Male; Middle Aged; Original; Paraquat - blood; Paraquat - poisoning; Predictive Value of Tests; Retrospective Studies; Survivors; Tomography, X-Ray Computed; 의학일반; Paraquat; Ground Glass Opacities; Lung; High Resolution Computerized Tomography; Predictive Measure
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2009.24.4.636

Even though plasma paraquat (PQ) levels have known to be an informative predictor, many patients succumb at low PQ levels in acute PQ intoxication. This study was designed to see whether the high resolution computerized tomography (HRCT) of the lungs would be a predictive measure in acute PQ intoxication. HRCT of the lungs was obtained from 119 patients with acute PQ intoxication on 7 days after PQ ingestion. The areas with ground glass opacities (GGOs) were evaluated at five levels with the area measurement tool of the picture archiving and communication systems. Among 119 patients, 102 survived and 17 died. The plasma PQ levels were significantly higher in the non-survivors than in the survivors (2.6+/-4.0 microg/mL vs. 0.2+/-0.4 microg/mL, P=0.02). The area with GGOs was 2.0+/-6.4% in the survivors and 73.0+/- 29.9% in the non-survivors (P<0.001). No patients survived when the area with GGOs was more than 40% but all of the patients survived when the area affected by GGOs was less than 20%. In conclusion, the area of GGOs is a useful predictor of survival in acute PQ intoxication, especially in patients with low plasma PQ levels.