Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Multidisciplinary Approach to the Management of Aluminium Phosphide Poisoning – Experience From A Tertiary Care Hospital


Affiliations
1 Department of Cardiology, Seth G. S. Medical College and K. E. M. Hospital, Parel, Mumbai – 400012, Maharashtra, India
2 Department of Pharmacology, Vedanta Institute of Medical Sciences, Dahanu – 401606, Maharashtra, India
3 Department of Forensic Medicine, H. B. T. Medical College and Cooper Hospital, Mumbai – 400056, Maharashtra, India
     

   Subscribe/Renew Journal


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.

Keywords

Aluminium Phosphide Toxicity, Multidisciplinary Treatment, Rodenticide Poisoning
User
Subscription Login to verify subscription
Notifications
Font Size

  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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

Abstract Views: 86

PDF Views: 0




  • Multidisciplinary Approach to the Management of Aluminium Phosphide Poisoning – Experience From A Tertiary Care Hospital

Abstract Views: 86  |  PDF Views: 0

Authors

Dheeraj B. More
Department of Cardiology, Seth G. S. Medical College and K. E. M. Hospital, Parel, Mumbai – 400012, Maharashtra, India
Harshad Malve
Department of Pharmacology, Vedanta Institute of Medical Sciences, Dahanu – 401606, Maharashtra, India
Mahendra N. Wankhede
Department of Forensic Medicine, H. B. T. Medical College and Cooper Hospital, Mumbai – 400056, Maharashtra, India

Abstract


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.

Keywords


Aluminium Phosphide Toxicity, Multidisciplinary Treatment, Rodenticide Poisoning

References