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VOLUME 19 , ISSUE 12 ( 2015 ) > List of Articles

CASE REPORT

Successful management of aluminium phosphide poisoning using intravenous lipid emulsion: Report of two cases

Udismita Baruah, Ameeta Sahni, Harish C. Sachdeva

Keywords : Aluminum phosphide, lipid emulsions, magnesium sulfate

Citation Information : Baruah U, Sahni A, Sachdeva HC. Successful management of aluminium phosphide poisoning using intravenous lipid emulsion: Report of two cases. Indian J Crit Care Med 2015; 19 (12):735-738.

DOI: 10.4103/0972-5229.171412

License: CC BY-ND 3.0

Published Online: 00-12-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aluminum phosphide (ALP) is a cheap, easily available agricultural pesticide which causes lethal poisoning by liberation of phosphine and inhibition of cytochrome c oxidase thereby leading to cellular hypoxia. Although there is no known specific antidote, clinical trials are still going on. We present here two cases of ALP poisoning who were successfully managed by treatment with lipid emulsion and intravenous magnesium sulfate.


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  1. Moghadamnia AA. An update on toxicology of aluminum phosphide. Daru 2012;20:25.
  2. Behera C, Krishna K, Bhardwaj DN, Rautji R, Kumar A. A case of accidental fatal aluminum phosphide poisoning involving humans and dogs. J Forensic Sci 2015;60:818-21.
  3. Rigobello MP, Scutari G, Boscolo R, Bindoli A. Induction of mitochondrial permeability transition by auranofin, a gold (I)-phosphine derivative. Br J Pharmacol 2002;136:1162-8.
  4. Valmas N, Zuryn S, Ebert PR. Mitochondrial uncouplers act synergistically with the fumigant phosphine to disrupt mitochondrial membrane potential and cause cell death. Toxicology 2008;252:33-9.
  5. Wang W, Winther JR, Thorpe C. Erv2p: Characterization of the redox behavior of a yeast sulfhydryl oxidase. Biochemistry 2007;46:3246-54.
  6. Almasieh M, Lieven CJ, Levin LA, Di Polo A. A cell-permeable phosphine-borane complex delays retinal ganglion cell death after axonal injury through activation of the pro-survival extracellular signal-regulated kinases 1/2 pathway. J Neurochem 2011;118:1075-86.
  7. Proudfoot AT. Aluminium and zinc phosphide poisoning. Clin Toxicol (Phila) 2009;47:89-100.
  8. Glindemann D, Eismann F, Bergmann A, Kuschk P, Stottmeister U. Phosphine by bio-corrosion of phosphide-rich iron. Environ Sci Pollut Res Int 1998;5:71-4.
  9. Chugh SN, Ram S, Chugh K, Malhotra KC. Spot diagnosis of aluminium phosphide ingestion: An application of a simple test. J Assoc Physicians India 1989;37:219-20.
  10. Khosla SN, Nand N, Khosla P. Aluminium phosphide poisoning. J Trop Med Hyg 1988;91:196-8.
  11. Mehrpour O, Jafarzadeh M, Abdollahi M. A systematic review of aluminium phosphide poisoning. Arh Hig Rada Toksikol 2012;63:61-73.
  12. Gurjar M, Baronia AK, Azim A, Sharma K. Managing aluminum phosphide poisonings. J Emerg Trauma Shock 2011;4:378-84.
  13. Nasri Nasrabadi Z, Marashi SM. Comments on "A systematic review of aluminium phosphide poisoning". Arh Hig Rada Toksikol 2012;63:551.
  14. Mirakbari SM. Hot charcoal vomitus in aluminum phosphide poisoning - A case report of internal thermal reaction in aluminum phosphide poisoning and review of literature. Indian J Anaesth 2015;59:433-6.
  15. Bajwa SJ, Bajwa SK, Kaur J, Singh K, Panda A. Management of celphos poisoning with a novel intervention: A ray of hope in the darkest of clouds. Anesth Essays Res 2010;4:20-4.
  16. Shadnia S, Rahimi M, Pajoumand A, Rasouli MH, Abdollahi M. Successful treatment of acute aluminium phosphide poisoning: Possible benefit of coconut oil. Hum Exp Toxicol 2005;24:215-8.
  17. Cave G, Harvey M, Graudins A. Intravenous lipid emulsion as antidote: A summary of published human experience. Emerg Med Australas 2011;23:123-41.
  18. O′Neil MJ, editor. The Merck Index - An Encyclopedia of Chemicals, Drugs, and Biologicals. 13 th ed. Whitehouse Station, NJ: Merck and Co., Inc.; 2001. p. 1317.
  19. Chugh SN, Kolley T, Kakkar R, Chugh K, Sharma A. A critical evaluation of anti-peroxidant effect of intravenous magnesium in acute aluminium phosphide poisoning. Magnes Res 1997;10:225-30.
  20. Agrawal VK, Bansal A, Singh RK, Kumawat BL, Mahajan P. Aluminum phosphide poisoning: Possible role of supportive measures in the absence of specific antidote. Indian J Crit Care Med 2015;19:109-12.
  21. Harvey M, Cave G. Case report: Successful lipid resuscitation in multi-drug overdose with predominant tricyclic antidepressant toxidrome. Int J Emerg Med 2012;5:8.
  22. Marashi SM, Nasri-Nasrabadi Z. Can sodium bicarbonate really help in treating metabolic acidosis caused by aluminium phosphide poisoning? Arh Hig Rada Toksikol 2015;66:83-4.
  23. Cooper DJ, Walley KR, Wiggs BR, Russell JA. Bicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. A prospective, controlled clinical study. Ann Intern Med 1990;112:492-8.
  24. Soltani M, Shetab-Boushehri SF, Mohammadi H, Shetab-Boushehri SV. Proposing boric acid as an antidote for aluminium phosphide poisoning by investigation of the chemical reaction between boric acid and phosphine. J Med Hypotheses Ideas 2013;7:21-4.
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