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VOLUME 25 , ISSUE 12 ( December, 2021 ) > List of Articles

CASE REPORT

Venoarterial Extracorporeal Membrane Oxygenation is Effective in Severe Aluminum Phosphide Overdose Despite Delayed Presentation

Pradeep Kumar HG, A Madhusudan Kalluraya, C Jithendra, Ashwin Kumar, Sudhindra P Kanavehalli, Arul D Furtado, Ravindra Mehta

Keywords : Aluminum phosphide, ECMO, Multi-organ dysfunction

Citation Information : HG PK, Kalluraya AM, Jithendra C, Kumar A, Kanavehalli SP, Furtado AD, Mehta R. Venoarterial Extracorporeal Membrane Oxygenation is Effective in Severe Aluminum Phosphide Overdose Despite Delayed Presentation. Indian J Crit Care Med 2021; 25 (12):1459-1461.

DOI: 10.5005/jp-journals-10071-24041

License: CC BY-NC 4.0

Published Online: 17-12-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aluminum phosphide (ALP) is a potentially lethal poison. The mortality rate in ALP overdose is close to 100%. ALP has no specific antidote, and only supportive therapy is possible, with timely extracorporeal support mentioned as a modality. We present a case of severe ALP overdose in a young female with delayed presentation (>24 hours) and multiorgan failure (MOF)/shock successfully managed with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Unique features of this case include consumption of lethal quantity of ALP (5 g), severe toxicity with MOF, and shock secondary to a delayed presentation, all of which incrementally added to a high mortality. This was managed with the help of VA-ECMO as a last option with a successful outcome. This highlights the fact that late ECMO deployment, despite absorption of a large quantity and MOF/shock/acidosis, can still be salvageable with appropriate management.


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