Supportive Measures in the Treatment of Aluminum Phosphide Poisoning as a Trial to Reduce Mortality at Assiut University Hospital, Egypt

Abstract

Aluminum phosphide (AlP) poisoning is a major problem, accounting for many Emergency Unit visits and hospitalization with increasing incidence of AlP toxicity in the last few years. In spite of the progress achieved in the field of toxicology and associated therapies, AlP is still responsible for a high rate of mortality due to the rapid onset of life-threatening symptoms, ineffective treatment and inadequate data on the efficacy of therapeutic interventions. AlP poisoning is a serious medical emergency demanding early and adequate management. In this prospective study of AlP toxicity, 44 patients admitted to emergency unit of Assiut university hospital in the period from 1st January to 30th June 2016 were included. There were 28 males (68.2%) and 16 females (31.8%). The majority of the cases were in the age group from 21 to 30 years (n=28, 54.6%). Thirty-six (81.8%) of admitted patients were from rural areas. Suicidal intake was the main mode of toxicity in 81.8% of cases. About 41% of the cases were shocked at their presentation and had metabolic acidosis. The mortality rate was 45.5%. The incidence of death in patients treated with N-acetyl cysteine to the incidence of death in non-treated patients was 1:12. AlP poisoning needs more attention due to associated fatality, the absence of an antidote, and a high number of youth victims. Supportive measures are vital in these patients. N-acetyl cysteine has a protective effect.

Keywords

• forensic science
• aluminum phosphide poisoning
• cardiotoxicity
• pesticides
• emergency
• n-acetyl cysteine.