Aluminum phosphide poisoning: Possible role of supportive measures in the absence of specific antidote

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Ranjeet Kumar Singh
2. Vijay Kumar Agrawal
3. Parul Mahajan
4. Bhanwar Lal Kumawat
ISSN
0972-5229
DOI
10.4103/0972-5229.151019
Volume
19
Issue
2
Publishing Year
2015
Pages
4
Author Affiliations
    1. Department of Critical Care Medicine and Pulmonology, Metro Heart Institute with Multispeciality, Sector 16A, Faridabad, Haryana, India
    1. Department of Critical Care Medicine and Pulmonology, Metro Heart Institute with Multispeciality, Sector 16A, Faridabad, Haryana, India
    1. Department of Critical Care Medicine and Pulmonology, Metro Heart Institute with Multispeciality, Sector 16A, Faridabad, Haryana, India
    1. Department of Critical Care Medicine and Pulmonology, Metro Heart Institute with Multispeciality, Sector 16A, Faridabad, Haryana, India
  • Article keywords
    Aluminum phosphide, coconut oil, magnesium sulfate, phosphine gas, potassium permanganate

    Abstract

    Aluminum phosphide (ALP) poisoning is one of the major causes of suicidal deaths. Toxicity by ALP is caused by the liberation of phosphine gas, which rapidly causes cell hypoxia due to inhibition of oxidative phosphorylation, leading to circulatory failure. Treatment of ALP toxicity is mainly supportive as there is no specific antidote. We recently managed 7 cases of ALP poisoning with severe hemodynamic effects. Patients were treated with supportive measures including gastric lavage with diluted potassium permanganate, coconut oil and sodium-bicarbonate first person account should be avoided in a scientific paper. Intravenous magnesium sulfate, proper hemodynamic monitoring and vasopressors. Four out of 7 survived thus suggesting a role of such supportive measures in the absence of specific antidote for ALP poisoning.

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