Evaluation of the Role of Intravenous Lipid Emulsion as a Putative Treatment for Acute Aluminum Phosphide Poisoning.

Abstract

KEYWORDS Aluminum phosphide toxicity (ALP) "Wheat pill"; Antidote; Intralipid emulsion (ILE); Survival time; Mortality rate. The study aimed to evaluate the effect of intravenous lipid emulsion (ILE) as a putative antidote on the survival time of ALP intoxicated patients and whether it ameliorates the clinical outcome or not. The present clinical study was conducted in Mansoura Emergency Hospital, and it involves patients presented with acute aluminum phosphide poisoning (ALP). Sociodemographic and full clinical examination was documented. Patients received either the standard therapy or standard therapy plus ILE. Over five years, a total of 87 acutely intoxicated patients were analyzed of which (56 were females (64.4%), and 31 were males (35.6%). The mean age was 28.23±9.69 years. The mortality rate for ALP poisoning was 67.8%. Despite the poor outcome of cardiopulmonary resuscitation (CPR) following ALP toxicity, the survival time among patients who received ILE was significantly longer compared to the group of patients who received only standard therapy, in which 7.3% versus 30.4% survived 6-24 hours, 34.1% versus 21.7% survived 25-48 hours while 36.6% versus 6.5% survived between 49-72 hours respectively with p-value=<0.001. From previous data, it can be concluded that the use of ILE as an antidote during resuscitative measures following ALP toxicity showed a slight improvement in terms of survival time, however, it doesn't decrease the mortality rate. Further studies are imperative to prove the effectiveness of ILE as an antidote for ALP toxicity and whether it could be considered in the CPR measures of poisoning cases.