A Novel Protocol for Gastric Lavage in Patients with Aluminum Phosphide Poisoning: A Double-Blind Study
AbstractAluminum phosphide poisoning (ALPP) still has no efficient and approved antidote. Supportive care and hemodynamic monitoring are the only choices of treatment. We proposed a new lavage formulation in addition to evaluation of its efficacy and defining the impact of clinical characteristics of patients on their prognosis. During eight months period of time, 120 patients were enrolled to the study and randomly received two different gastric lavage protocols. Our new lavage protocol had positive impact on patients' survival and the P-value in comparison with the classic gastric lavage method was close to significant level (P=0.054). On hospital arrival indication for intubation-ventilation as well as sense of thirst, sore throat and absence of nausea indicate worse outcome. Using our novel approach, indication for intubation-ventilation as well as sense of thirst, sore throat and absence of nausea can be considered as applicable prognostic factors in survival of ALPP patients. Further studies are required to set this approach as preferred treatment.
Bajaj R, Wasir HS. Epidemiology of aluminium phosphide poisoning. Need for a survey. J Assoc Physicians India1990;38(3):197-8.
Moghadamnia AA, Abdollahi M. An epidemiological study of poisoning in northern Islamic Republic of Iran.East Mediterr Health J 2002;8(1):88-94.
Shadnia S, Rahimi M, Pajoumand A, Rasouli MH, Abdollahi M. Successful treatment of acute aluminium phosphide poisoning: possible benefit of coconut oil. HumExp Toxicol 2005;24(4):215-8.
Kabra SG, Narayanan R. Aluminium phosphide: worse than Bhopal. Lancet 1988;1(8598):1333.
Singh S, Wig N, Choudhary D, Sood NK, Sharma BK.Changing pattern of acute poisoning in adults: Experienceof a large north-west Indian hospital (1970-1989). J Assoc Physc India 1997;45:194-7.
Proudfoot AT. Aluminium and zinc phosphide poisoning. Clin Toxicol (Phila) 2009;47(2):89-100.
Jaiswal S, Verma RK, Tewari N. Aluminum phosphide poisoning: effect of correction of severe metabolic acidosison patient outcome. Indian J Crit Care Med 2009;13(1):21-4.
Chugh SN. Aluminium phosphide poisoning: present status and management. J Assoc Physicians India 1992;40(6):401-5.
Gurjar M, Baronia AK, Azim A, Sharma K. Managing aluminum phosphide poisonings. J Emerg Trauma Shock 2011;4(3):378-84.
Shadnia S, Soltaninejad K, Hassanian-Moghadam H,Sadeghi A, Rahimzadeh H, Zamani N, Ghasemi-Toussi A, Abdollahi M. Methemoglobinemia in aluminum phosphide poisoning. Hum Exp Toxicol 2011;30(3):250-3.
Pajoumand A, Jalali N, Abdollahi M, Shadnia S. Survival following severe aluminum phosphide poisoning. J PharmPract Res 2002;32:297-9.
Goswami M, Bindal M, Sen P, Gupta SK, Avasthi R, Ram BK. Fat and oil inhibit phosphine release from aluminium phosphide: its clinical implication. Indian J Exp Biol 1994;32(9):647-9.
Abder-Rahman HA, Battah AH, Ibraheem YM, Shomaf MS, el-Batainch N. Aluminum phosphide fatalities, new local experience. Med Sci Law 2000;40(2):164-8.
Goel A, Aggarwal P. Pesticide poisoning. Natl Med J India 2007;20(4):182-91.
Shadnia S, Sasanian G, Allami P, Hosseini A, Ranjbar A, Amini-Shirazi N, Abdollahi M. A retrospective 7-years study of aluminum phosphide poisoning in Tehran: opportunities for prevention. Hum Exp Toxicol 2009;28(4):209-13.
Singh S, Singh D, Wig N, Jit I, Sharma BK. Aluminum phosphide ingestion: a clinico-pathologic study. J Toxicol Clin Toxicol 1996;34(6):703-6.