Detection of Different Prognostic Factors and Their Relation With the Outcome Clinical Trial
Official title:
Supportive Measures in Treatment of Aluminum Phosphide Poisoning as a Trial to Reduce Mortality at Assiut University Hospital
Aluminum phosphide poisoning (ALP) is a global public health problem, and self-poisoning accounts for one-third of the world's suicide rate. In fact, in some parts of developing countries, pesticide poisoning causes more deaths than infection. ALP is very common in our government and the prognosis of the cases is usually so bad. Toxicity by ALP is caused by the liberation of phosphine gas, which causes cell hypoxia due to inhibition of oxidative phosphorylation leading to circulatory failure.
Aluminum phosphide poisoning is a major problem, accounting for many Emergency Unit visits
and hospitalization, the incidence of aluminum phosphide poisoning increasing in the last few
years.
ALP is used as pesticides for many years to protect grains in stores and during its
transportation. The availability of these tablets and their low cost make it an easy and
common method of suicide in our country with the increasing incidence of social and financial
problems that face the youth.
In management, the main objective is to provide effective oxygenation, ventilation, and
circulation until phosphine is excreted. All patients of severe ALP poisoning require
continuous invasive hemodynamic monitoring and early resuscitation with fluid and vasoactive
agents. N- acetylcysteine as an antioxidant and cytoprotective agent reduces myocardial
oxidative injury and increase survival time. Magnesium sulfate helps in scavenging free
radicals through glutathione (GSH) recovery hence is effective as a parenteral antioxidant in
this poisoning as well as has been tried for its general membrane stabilizing effect in
cardiac cells .
Death after 24 hours occurs usually owing to shock, cardiac arrhythmia, metabolic acidosis,
and acute respiratory distress syndrome.
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