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Successfully managed aluminum phosphide poisoning: A case report
Srijana Katwal1, Kiran Malbul1, Sujit Kumar Mandal1
1Shree Birendra Hospital, Chhauni, Kathmandu, Nepal.
Annals of Medicine and Surgery (2012)
|October 4, 2021
Summary
Aluminum phosphide (ALP) poisoning is often fatal, but this case highlights survival after severe poisoning. Early supportive care and potential use of magnesium sulfate and trimetazidine may improve outcomes.
Area of Science:
- Toxicology
- Emergency Medicine
- Cardiology
Background:
- Aluminum phosphide (ALP) is a widely used pesticide in Nepal, releasing toxic phosphine gas upon ingestion.
- ALP poisoning can cause severe complications including refractory shock, metabolic acidosis, cardiac arrhythmia, renal, and hepato-biliary impairment.
Observation:
- A 17-year-old girl ingested 6g of ALP tablets with suicidal intent.
- Despite ingesting a potentially lethal dose, she survived despite developing severe metabolic acidosis, acute renal failure, refractory shock, and ventricular tachycardia.
Findings:
- The case demonstrates survival from severe Aluminum phosphide poisoning, a condition with historically high mortality rates (70-100%).
- Emerging evidence suggests potential benefits from magnesium sulfate, trimetazidine, and advanced interventions like ECMO in managing ALP poisoning.
Implications:
- There is no definitive antidote for Aluminum phosphide poisoning.
- Early supportive management, intensive monitoring, and the use of membrane stabilizers and cardio-protective agents are crucial for reducing fatalities.
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