Therapeutic effects of hemoperfusion in treating long-acting anticoagulant rodenticide poisoning

Introduction: Second-generation anticoagulant rodenticides often cause severe bleeding that can be life-threatening, and have limited effective treatment options. This study aimed to evaluate the therapeutic efficacy of hemoperfusion in patients with rodenticide poisoning. Methods: We retrospectively analyzed data of 148 patients diagnosed with rodenticide poisoning at the Fifth Medical Center of the Chinese PLA General Hospital (China) between 2014 and 2021. The patients were divided into hemoperfusion and non-hemoperfusion groups based on whether or not they had received blood purification treatment. We compared clinical characteristics, serum drug concentrations, durations of hospital stay, and durations of vitamin K1 (VK1) therapy between the two groups using univariate and multivariate analyses. Subgroup analyses were also conducted to assess the effect of hemoperfusion in patients poisoned with brodifacoum and bromadiolone. Results: Of 148 screened patients, 115 patients were included (hemoperfusion [n=24] and non-hemoperfusion [n=91]). The rate of blood toxin clearance per unit time may have been faster in the hemoperfusion group. Subgroup analyses revealed that hemoperfusion significantly reduced the duration of VK1 therapy in patients poisoned with brodifacoum (P=0.044). Conclusion: Hemoperfusion effectively reduced serum rodenticide concentrations in patients with poisoning. Moreover, hemoperfusion can reduce the duration of VK1 therapy in patients poisoned by brodifacoum.