Multidisciplinary Approach to the Management of Aluminium Phosphide Poisoning – Experience from a Tertiary Care Hospital
DOI:
https://doi.org/10.18311/ti/2021/v28i4/28095Keywords:
Aluminium Phosphide Toxicity, Multidisciplinary Treatment, Rodenticide PoisoningAbstract
A usual ingredient of rodenticide, aluminium phosphide is known for its poisoning which happens to be one of the common causes of suicides in India. Signs and symptoms of toxicity with aluminium phosphide are wellknown. Circulatory failure plays an important role in mortality with aluminium phosphide poisoning. Aluminium phosphide poisoning is associated with high mortality as there is no specific antidote available yet. There is a need for correct treatment approach to manage this fatal poisoning. In this retrospective analysis we present a data of forty cases registered at a tertiary care hospital in Mumbai. We developed a multidisciplinary treatment approach to aluminium phosphide poisoning which may help in better patient outcomes. Correct treatment protocol with supportive therapy resulted in better survival in these patients. Hence we propose this aggressive, appropriate management with continuous haemodynamic monitoring and multidisciplinary treatment approach to reduce the mortality in aluminium phosphide poisoning.Downloads
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Accepted 2021-08-21
Published 2021-12-22
References
Chugh SN, Dushyant Ram S, Arora B, Malhotra KC. Incidence and outcome of aluminium phosphide poisoning in a hospital study. Indian J Med Res. 1991; 94:232-5.
Singh S, Singh D, Wig N, Jit I, Sharma BK. Aluminum phosphide ingestion - a clinico-pathologic study. J Toxicol Clin Toxicol. 1996; 34(6):703–6.PMid:8941200. https://doi.org/10.3109/15563659609013832 DOI: https://doi.org/10.3109/15563659609013832
Wahab A, Zaheer MS, Wahab S, Khan RA. Acute aluminium phosphide poisoning: An update. Hong Kong Journal of Emergency Medicine. 2008; 15(3):152–5. https://doi.org/10.1177/102490790801500306 DOI: https://doi.org/10.1177/102490790801500306
Chugh SN, Pal R, Singh V, Seth S. Serial blood phosphine levels in acute aluminium phosphide poisoning. J Assoc Physicians India. 1996; 44(3):184–5.
Gurjar M, Baronia AK, Azim A, Sharma K. Managing aluminum phosphide poisonings. J Emerg Trauma Shock. 2011; 4(3):378–84. PMid:21887030 PMCid:PMC3162709. https://doi.org/10.4103/0974-2700.83868 DOI: https://doi.org/10.4103/0974-2700.83868
Chugh SN, Kumar P, Aggarwal HK, Sharma A, Mahajan SK, Malhotra KC. Efficacy of magnesium sulphate in aluminium phosphide poisoning - comparison of two different dose schedules. J Assoc Physicians India. 1994; 42(5):373–5.
Goel A, Aggarwal P. Pesticide poisoning. Natl Med J India. 2007; 20(4):182–91.
Sudakin DL. Occupational exposure to aluminium phosphide and phosphine gas? A suspected case report and review of the literature. Hum Exp Toxicol. 2005; 24(1):27–33. PMid:15727053. https://doi.org/10.1191/0960327105ht496oa DOI: https://doi.org/10.1191/0960327105ht496oa
Gupta S, Ahlawat SK. Aluminum phosphide poisoning - a review. J Toxicol Clin Toxicol. 1995; 33(1):19–24. PMid:7837309. https://doi.org/10.3109/15563659509020211 DOI: https://doi.org/10.3109/15563659509020211
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(2):109–12. PMid:25722553 PMCid:PMC4339895. https://doi.org/10.4103/0972-5229.151019 DOI: https://doi.org/10.4103/0972-5229.151019
Mathai A, Bhanu MS. Acute aluminium phosphide poisoning: Can we predict mortality? Indian J Anaesth. 2010; 54(4):302–7. PMid:20882171 PMCid:PMC2943698. https://doi.org/10.4103/0019-5049.68372 DOI: https://doi.org/10.4103/0019-5049.68372
Singh D, Jit I, Tyagi S. Changing trends in acute poisoning in Chandigarh zone: A 25-year autopsy experience from a tertiary care hospital in northern India. Am J Forensic Med Pathol. 1999; 20(2):203–10. PMid:10414665. https://doi.org/10.1097/00000433-199906000-00019 DOI: https://doi.org/10.1097/00000433-199906000-00019
Singh D, Dewan I, Pandey AN, Tyagi S. Spectrum of unnatural fatalities in the Chandigarh zone of northwest India - a 25 year autopsy study from a tertiary care hospital. J Clin Forensic Med. 2003; 10(3):145–52. https://doi.org/10.1016/S1353-1131(03)00073-7 DOI: https://doi.org/10.1016/S1353-1131(03)00073-7
Siwach SB, Gupta A. The profile of acute poisonings in Harayana-Rohtak Study. J Assoc Physicians India. 1995; 43(11):756–9.
Wiwanitkit V. Aluminum phosphide poisoning. Indian J Crit Care Med. PMid:20040819 PMCid:PMC2823103. https://doi.org/10.4103/0972-5229.58547 DOI: https://doi.org/10.4103/0972-5229.58547
Lall SB, Sinha K, Mitra S, Seth SD. An experimental study on cardiotoxicity of aluminium phosphide. Indian J Exp Biol. 1997; 35:1060–4.
Bogle RG, Theron P, Brooks P, Dargan PI, Redhead J. Aluminium phosphide poisoning. Emerg Med J. 2006; 23:e3. PMid:16373788 PMCid:PMC2564148.https://doi.org/10.1136/emj.2004.015941 DOI: https://doi.org/10.1136/emj.2004.015941
Mathur A, Swaroop A, Aggarwal A. ECG changes in aluminium phosphide and organo phosphorus poisoning. Indian Pract. 1999; 52:249–52.
Karanth S, Nayyar V. Rodenticide-induced Hepatotoxicity. J Assoc Physicians India. 2005; 51:316– 7.
Suman RL, Savani M. Pleural effusion-A rare complication of aluminium phosphide poisoning. Indian Paediatr. 1999; 36:1161–3.
Chugh SN. Aluminium phosphide in Lall SB, Essentials of Clinical Toxicology. New Delhi: Narosa Publishing House; 1990.
Malve HO. Forensic pharmacology: An important and evolving subspecialty needs recognition in India. J Pharm Bioallied Sci. 2016; 8(2):92–7. PMid:27134459 PMCid:PMC4832912. https://doi.org/10.4103/0975-7406.171698 DOI: https://doi.org/10.4103/0975-7406.171698
Malve H. Understanding Forensic Pharmacology: What Indian physicians need to know? J Assoc Physicians India. 2017; 65(2):74–5. https://doi.org/10.22506/ti/2016/v23/i2/146707
Malve H. Understanding Forensic Pharmacology: What Indian pharmacologists need to know? Toxicol Int. 2016; 23(2):205–6. https://doi.org/10.22506/ti/2016/v23/i2/146707 DOI: https://doi.org/10.22506/ti/2016/v23/i2/146707