Journal of Anaesthesia & Critical Care Case Reports

Vol 5 | Issue 3 | Sep-Dec 2019 | page: 18-20  | Mamta Jain, Vandna Arora, Anil Kumar, Anish K Singh

Authors: Dr. Mamta Jain [1], Dr. Vandna Arora [1], Dr. Anil Kumar [1], Dr. Anish K Singh[1]

Address of Correspondence

1 Department of Anesthesiology and Critical Care, Pandit Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India.

Dr. Vandna Arora,
Pt . BDS PGIMS, Rohtak, Haryana, India.
Email: drvandna4@gmail.com

Introduction: Aluminium phosphide is an easily accessible pesticide which is a common cause of suicidal poisoning in developing countries. It is lethal as there is no specific antidote. We came across only one previous case report citing the successful use of intravenous lipid emulsion to treat aluminium phosphide poisoning.
Case report: We present a case of 39 year old male with aluminium phosphide poisoning successfully managed with intravenous intralipid emulsion and magnesium sulphate.
Conclusion: Although the management is primarily supportive, newer management strategies like coconut oil lavage, intralipid emulsion, digoxin use and magnesium sulphate infusion have claimed improved survival.
Keywords: Aluminium phosphide, Intralipid emulsion, Magnesium sulphate

References

1. Vaghefi SS, Emamhadi MA. Aluminium phosphide poisoning: a case report. International Journal of Medical toxicity and Forensic Medicine 2014;4(4):149- 53.
2. Chugh SN. Aluminium phosphide poisoning: Present status and management. J Assoc Physicians India 1992;40:401-5.
3. Gurjar M, Baronia AK, Azim A, Sharma K. Managing aluminium phosphide poisonings. J Emerg Trauma Shock 2011;4(3):378-84.
4. Baruah U, Sahni A, Sachdeva HC. Successful management of aluminium phosphide poisoning using intravenous lipid: Report of two cases. Indian J Crit Care Med
2015;19:735-8.
5. Singh S, Bhalla A, Verma SK, Kaur A, Gill K. Cytochrome-c oxidaseinhibition in 26 aluminium phosphide poisoned patients. Clin. Toxicol. 2006;44(2):155-8.
6. Goel A, Aggarwal P. Pesticide poisoning. Natl Med J India 2007;20:182-91.
7. Sudakin DL. Occupational exposure to aluminium phosphide and phosphine gas? A suspected case report and review of the literature. Hum Exp Toxicol.2005;24:27-33.
8. Gupta S, Ahlawat SK. Aluminium phosphide poisoning-a review. J Toxicol Clin
Toxicol. 1995;33:19-24.
9. Chugh SN, Ram S, Chugh K, Malhotra KC. Spot diagnosis of aluminium phosphide ingestion: An application of a simple test. J Assoc Physicians India 1989;37:219-20.
10. Khosla SN, Nand N, Khosla P. Aluminium phosphide poisoning . J Trop Med IIyg. 1988;91:196-8.
11. Mehrpour O, Jafarzadeh M, Abdollahi M. A systematic review of aluminium phosphide poisoning. Arh IIig Rada Toksikol 2012;63:61-73.
12. Bajwa S, Kaur S, Kaur J, Singh K, Panda A. Management of celphos poisoning with a novel intervention: A ray of hope in the darkest of clouds. Anesth Essays Res 2010;4:20-4.
13. Cave G, Harvey M, Grandins A. Intravenous lipid emulsionas antidote: A summary of published human experience. Emerg Med Australas 2011;23:123-41.
14. Cooper DJ, Walley KR, Wiggs BR, Russel JA. Bicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. A prospective, controlled clinical study. Ann Intern Med.1990;112:492-8.
15. Mehrpour O, Farzaneh E, Abdollahi M. Successful treatment of aluminium phosphide poisoning with digoxin: A case report and review of literature. Int J Pharmacol 2011;7:761-4.
16. Chugh SN, Kolley T, Kakkar R, Chugh K, Sharma A. A critical evaluation of antiperoxidant effect of intravenous magnesium in acute aluminium phosphide poisoning. Magnes Res. 1997;10:225-30.
17. Chugh SN, Jaggal KL, Sharma A, Arora B, Malhotra KC. Magnesium levels in acute cardiotoxicity due to aluminium phosphide poisoning. Indian J Med Res. 1991;94:437-9.
18. Karimani A, Mohammadpour AH, Zirak MR, Rezaee R, Megarbane B, Tsatsakis A, Karimi G. Antidotes for aluminium phosphide poisoning-An update. Toxicol Rep. 2018;5:1053-1059.
19. Agrawal VK, Bansal A, Singh RK, Kumawat BL, Mahajn M. Aluminium phosphide poisoning: Possible role of supportive measuresin the absence of specific antidote. Indian J Crit Care Med. 2015;19:109-12.
20. Chugh SN, Arora V, Sharma A, Chugh K. Free radical scavengers and lipid peroxidation in acute aluminium phosphide poisoning. Indian J Med Res. 1996;104:190-3.

(Abstract) (Full Text HTML)      (Download PDF)

.