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.