A case which oxygen is contrendicated: Paraquat intoxication

Abstract

Paraquat is a highly toxic herbicide. Poisoning with paraquat is rare in our country since its use is restricted. We would like to review the treatment approach which is quite different from other poisonings by presenting the case we came across for the first time in our clinic and resulted in death in a very short time. A 43 year old patient was presented to emergency room after ingestion of a half cup of paraquat in a suicide attempt. His examination findings were normal except hyperemia in oropharynx. The patient was started on methylprednisolone and cyclophosphamide to avoid pulmonary fibrosis. He was intubated and started on low tidal volume ventilation due to respiratory distress. Ulcerated lesions were observed on hypopharynx and vocal cords during intubation. The patient developed multiple organ failures in the first 24 hours of admission, died to suddenly developed bradycardia and asystole in the third day of follow up.