[An evidence-based treatment design for paraquat (PQ) poisoning]

To optimize the treatment of PQ poisoning by a therapeutic regimen designed on the presently available clinical research reports following the principles of evidence-based medicine.

A treatment plan for a randomly chosen PQ poisoned patient was designed, with regard to the application of blood purification and immunosuppressor, following the suggestions in literatures adopted through computer aided search of Cochrane library (issue 1, 2010), MEDLINE (1950-2010.1) and China Biomedicine Literature Database (CBM, 1978-2010). The systematic evaluations,Meta-analysis and the randomized controlled trials (RCT) on treatment for PQ poisoning were collected to guide the design. A one year follow-up was conducted after the discharge of the patient.

7 articles matching the adoption criteria were analyzed. These reports demonstrate that blood purification and glucocorticoid combined with cyclophosphamide are effective against PQ poisoning. Blood purification can prolong the survival, but has little effect on mortality, whereas immunosuppressants increase the survival rate. With adjustment to the patient's condition, an evidence-based treatment plan was used for the patient upon her consent. The patient showed significant improvement throughout the hospitalization with no complication found during the follow-up.

With guidance from the latest research, an evidence-based treatment plan tailored to the patient's specific needs may benefit patient with PQ poisoning at least in short term. However, the long term effect of such measure still requires further studies with longer follow-up.