The effect of hyperinsulinemia-euglycemia on acute aluminum phosphide poisoning: a clinical trial

Abstract

Background: Aluminum Phosphide toxicity is a common deliberate toxicity, and due to no specific antidote available for its treatment, most toxicity leads to death. The present study aimed to evaluate the efficacy of Hyper Insulin Euglycemia protocol in combination with vitamin E and N-Acetyl Cysteine in patients with acute ALP poisoning treatment. Methods: In this incidental prospective clinical trial, 76 individuals with toxicity were enrolled and assigned into two groups: One treatment group undergoing by glucose, insulin, and potassium() administration in combination with vitamin E and N-Acetyl Cysteine, and one control group who were mainly managed by supportive treatments. Signs and symptoms at arrival and during hospitalization, complications, and outcomes were recorded and compared between these two groups to find any possible effect of, vitamin E, and protocol for toxicity treatment. Results: This study investigated the mortality and safety of therapy in 76 poisoning patients with an average age of 28. The mortality rate in the group was 26% lower than in the control group (p-value: 0.058). Furthermore, this research detected a significant rise in systolic blood pressure during hospitalization in the treatment group. Regarding pH and bicarbonate levels, the group showed less metabolic acidosis. In contrast to the case group, the therapy group's bicarbonate levels significantly increased throughout hospitalization. Conclusion: Using the, vitamin E, and protocol accompanied by Symptomatic and supportive treatments in acute ALP toxicity among the treatment group of this study resulted in a significant increase in systolic blood pressure, longer hospitalization duration, and lower death rates.

Keywords

• aluminum phosphide toxicity
• glucose-insulin- potassium
• hyper insulin euglycemia
• rice tablet