Could hydroxyethyl starch be a therapeutic option in management of acute aluminum phosphide toxicity?

Marashi, Sayed Mahdi; Arefi, Mohammad; Behnoush, Behnam; Nasrabad, Mahdi Ghazanfari; Nasrabadi, Zeynab Nasri

doi:10.1016/j.mehy.2011.01.009

Cited by 27 publications

(25 citation statements)

References 19 publications

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“…Another option for the management of AlP poisoning is hydroxyethyl starch (91). Leakage of fl uids from intravascular to extravascular space that leads to a strong refractory hypotension is one of the post-mortem fi ndings in AlP poisoning.…”

Section: Hydroxyethyl Starchmentioning

confidence: 99%

“…Leakage of fl uids from intravascular to extravascular space that leads to a strong refractory hypotension is one of the post-mortem fi ndings in AlP poisoning. Hydroxyethyl starch remains in the intravascular space as a colloid rather than as a crystalloid and thus reduces the extravascular leak of albumin and fluids (91). However, no experiment has yet investigated the use of starch in the management of AlP poisoning.…”

Section: Hydroxyethyl Starchmentioning

confidence: 99%

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A Systematic Review of Aluminium Phosphide Poisoning

Mehrpour¹,

Jafarzadeh

Abdollahi

2012

Archives of Industrial Hygiene and Toxicology

155

186

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Every year, about 300,000 people die because of pesticide poisoning worldwide. The most common pesticide agents are organophosphates and phosphides, aluminium phosphide (AlP) in particular. AlP is known as a suicide poison that can easily be bought and has no effective antidote. Its toxicity results from the release of phosphine gas as the tablet gets into contact with moisture. Phosphine gas primarily affects the heart, lungs, gastrointestinal tract, and kidneys. Poisoning signs and symptoms include nausea, vomiting, restlessness, abdominal pain, palpitation, refractory shock, cardiac arrhythmias, pulmonary oedema, dyspnoea, cyanosis, and sensory alterations. Diagnosis is based on clinical suspicion, positive silver nitrate paper test to phosphine, and gastric aspirate and viscera biochemistry. Treatment includes early gastric lavage with potassium permanganate or a combination with coconut oil and sodium bicarbonate, administration of charcoal, and palliative care. Specifi c therapy includes intravenous magnesium sulphate and oral coconut oil. Moreover, acidosis can be treated with early intravenous administration of sodium bicarbonate, cardiogenic shock with fl uid, vasopresor, and refractory cardiogenic shock with intra-aortic baloon pump or digoxin. Trimetazidine may also have a useful role in the treatment, because it can stop ventricular ectopic beats and bigeminy and preserve oxidative metabolism. This article reviews the epidemiological, toxicological, and clinical/pathological aspects of AlP poisoning and its management.

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Section: Hydroxyethyl Starchmentioning

confidence: 99%

Section: Hydroxyethyl Starchmentioning

confidence: 99%

A Systematic Review of Aluminium Phosphide Poisoning

Mehrpour¹,

Jafarzadeh

Abdollahi

2012

Archives of Industrial Hygiene and Toxicology

155

186

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“…Even though controversy continues about the exact mechanism of AlP toxicity and metabolic acidosis, all agree that AlP toxicity leads to H + ion efflux from the cell and, when H + diffuses outside the cells, to metabolic acidosis (2,(8)(9)(10)(11).…”

mentioning

confidence: 99%

Can sodium bicarbonate really help in treating metabolic acidosis caused by aluminium phosphide poisoning?

Marashi

Nasri-Nasrabadi

2015

Archives of Industrial Hygiene and Toxicology

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“…Refractory hypotension leads to circulatory failure and consequently metabolic acidosis. In this condition, cell metabolism will decrease to enhance the chance of cell survival (11). Even though our hypothesis has not yet been tested, it explains every fact about AlP poisoning.…”

Section: What Really Happens When Phosphine Is Adsorbedmentioning

confidence: 84%