Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,l...Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,leading to more poisoning incidents.It has a fatality rate as high as 76%after poisoning.[1]Here,we report a successful treatment of a patient with mixed pesticide poisoning caused by lethaldose emamectin benzoate(EB)and chlorfenapyr in the Department of Critical Care Medicine,Yangzhou Hongquan Hospital.展开更多
Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system di...Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system disturbances.This report presents a case of a middleaged female who developed extremely rare symptoms of optic nerve damage after ingesting a large amount of an organophosphate pesticide.展开更多
BACKGROUND:This study is to evaluate clearance eff ects of hemoperfusion(HP),continuous renal replacement therapy(CRRT),and plasma exchange(PE)for chlorfenapyr and its metabolite tralopyril in patients with acute pois...BACKGROUND:This study is to evaluate clearance eff ects of hemoperfusion(HP),continuous renal replacement therapy(CRRT),and plasma exchange(PE)for chlorfenapyr and its metabolite tralopyril in patients with acute poisoning.METHODS:This retrospective study included 18 patients with acute oral chlorfenapyr poisoning treated at our department between January 2022 and January 2024.All patients received conventional therapies combined with blood purification,including HP,CRRT,and PE.HP was performed three sessions within the fi rst 24 h,followed by CRRT and PE.Serial blood samples were collected to measure plasma concentrations of chlorfenapyr and tralopyril using gas chromatography/liquid chromatography-mass spectrometry(GC/LC-MS).The toxin-clearance eff ects were assessed using a linear mixed-eff ects(LME)model.RESULTS:The hourly decline rate of the plasma chlorfenapyr concentration(median[IQR])was 8.83%(1.79%)for HP,4.12%(1.26%)for CRRT,and 6.85%(1.44%)for PE.LME analysis showed higher decline rate in the plasma concentration with HP(β=5.00;P<0.001)and PE(β=2.15;P=0.003)compared to CRRT.For tralopyril,the hourly decline rates were 3.04%(0.62%)for HP,1.82%(0.48%)for CRRT,and 3.01%(0.37%)for PE.LME analysis showed that the clearance effects of HP(β=0.027;P<0.001)and PE(β=0.022;P=0.001)were superior to CRRT.Pre-treatment toxin levels and the interval from hospital admission to blood purifi cation showed no signifi cant interaction with clearance outcomes.CONCLUSION:In our study,HP was associated with a higher decline rate in plasma chlorfenapyr concentration compared to CRRT and PE,supporting HP as a preferred early intervention.However,all three methods showed limited effi cacy in reducing tralopyril levels.Further research into the toxicokinetics and mechanisms of chlorfenapyr is warranted to optimize purifi cation strategies.展开更多
文摘Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,leading to more poisoning incidents.It has a fatality rate as high as 76%after poisoning.[1]Here,we report a successful treatment of a patient with mixed pesticide poisoning caused by lethaldose emamectin benzoate(EB)and chlorfenapyr in the Department of Critical Care Medicine,Yangzhou Hongquan Hospital.
文摘Organophosphate pesticide poisoning is an acute form of poisoning primarily found in underdeveloped regions.Its main clinical manifestations include muscarinic symptoms,nicotinic symptoms,and central nervous system disturbances.This report presents a case of a middleaged female who developed extremely rare symptoms of optic nerve damage after ingesting a large amount of an organophosphate pesticide.
基金funded by the Medical Science Research Project of the Hebei Provincial Health and Health Commission(20230550).
文摘BACKGROUND:This study is to evaluate clearance eff ects of hemoperfusion(HP),continuous renal replacement therapy(CRRT),and plasma exchange(PE)for chlorfenapyr and its metabolite tralopyril in patients with acute poisoning.METHODS:This retrospective study included 18 patients with acute oral chlorfenapyr poisoning treated at our department between January 2022 and January 2024.All patients received conventional therapies combined with blood purification,including HP,CRRT,and PE.HP was performed three sessions within the fi rst 24 h,followed by CRRT and PE.Serial blood samples were collected to measure plasma concentrations of chlorfenapyr and tralopyril using gas chromatography/liquid chromatography-mass spectrometry(GC/LC-MS).The toxin-clearance eff ects were assessed using a linear mixed-eff ects(LME)model.RESULTS:The hourly decline rate of the plasma chlorfenapyr concentration(median[IQR])was 8.83%(1.79%)for HP,4.12%(1.26%)for CRRT,and 6.85%(1.44%)for PE.LME analysis showed higher decline rate in the plasma concentration with HP(β=5.00;P<0.001)and PE(β=2.15;P=0.003)compared to CRRT.For tralopyril,the hourly decline rates were 3.04%(0.62%)for HP,1.82%(0.48%)for CRRT,and 3.01%(0.37%)for PE.LME analysis showed that the clearance effects of HP(β=0.027;P<0.001)and PE(β=0.022;P=0.001)were superior to CRRT.Pre-treatment toxin levels and the interval from hospital admission to blood purifi cation showed no signifi cant interaction with clearance outcomes.CONCLUSION:In our study,HP was associated with a higher decline rate in plasma chlorfenapyr concentration compared to CRRT and PE,supporting HP as a preferred early intervention.However,all three methods showed limited effi cacy in reducing tralopyril levels.Further research into the toxicokinetics and mechanisms of chlorfenapyr is warranted to optimize purifi cation strategies.
