Fresh red blood cells transfusion protects against aluminum phosphide-induced metabolic acidosis and mortality in rats

Abstract

BackgroundAluminum phosphide (AlP) is used as pesticide in some countries for protection of stored grains. Human poisoning with AlP due to suicide attempt or accidental environmental exposure is associated with very high mortality partially due to development of severe metabolic acidosis. Previous studies have shown that hemoglobin has high buffering capacity and erythrocytes can potentially be used for management of metabolic acidosis. The aim of this study was to evaluate the effect of fresh packed red blood cells (RBC) transfusion on survival and cardiovascular function in AlP-poisoned rats.Methodology/Principal findingsRats were poisoned with AlP by gavage. Fresh packed RBC was transfused via tail vein after AlP administration. Acid-base balance, vital signs and mortality was assessed and compared in experimental groups. Infusion of fresh packed RBC (1.5 ml) one hour after AlP (4–15 mg/kg) intoxication was associated with a significant decrease in mortality rate. Packed RBC infusion improved blood pH, HCO3-, Na+ and Ca2+ levels. Plasma troponin level was also reduced and ECG changes were reversed following packed RBC infusion in AlP intoxicated rats.ConclusionsOur results showed that fresh RBC transfusion could ameliorate metabolic acidosis and enhance survival in AlP-poisoned rat. We assume that an increase in pool of RBCs may modulate acid-base balance or potentially chelate AlP-related toxic intermediates via phosphine-hemoglobin interaction.

Assessment of the Role of Total Antioxidant Capacity and Troponin I as Possible Predictors for Phosphides -Induced Cardiotoxicity

“…Concerning ECG intervals, QTc interval was prolonged in all ALP intoxicated patients and ZnP intoxicated patients with moderate symptoms. In agreement with the current study, several studies reported prolonged QTc interval accompanied with either bradycardia or tachycardia following acute exposure to metal phosphides (Lionate et al, 2004;Jafari et al, 2015;Taghaddosinejad et al, 2016;Asghari et al, 2017 andRahimi et al, 2018). Wide QRS complex was observed in 20.2 % of the studied patients.…”

Adjuvant potential of selegiline in treating acute toxicity of aluminium phosphide in rats

“…Despite the high mortality rate caused by AlP poisoning, underlying mechanisms of AlP toxicity are still not well known. It seems that released phosphine from AlP in the presence of water or gastric acid is responsible for the toxic effects of AlP . In most cases, the mortality rate has been reported with rice pill is more than 50% .…”

“…It seems that released phosphine from AlP in the presence of water or gastric acid is responsible for the toxic effects of AlP. 3,19,30,31 In most cases, the mortality rate has been reported with rice pill is more than 50%. 5,32,33 In our study, while selegiline-treated rats (1 mg/kg) induced better survival (only in AlP 12 mg/kg), other doses of selegiline did not change the survival time in AlP-poisoned rats.…”

“…AlP toxicity is associated with the separation of myocardial fibres by oedema, fragmentation of the fibres, non‐specific vacuolation of myocytes, focal necrosis, severe fall in blood pressure and heart rate. In addition, AlP induces electrocardiographic (ECG) abnormalities such as ST–T changes, QRS broadening, QTc prolongation, arrhythmia and conduction defects …”

“…In addition, AlP induces electrocardiographic (ECG) abnormalities such as ST-T changes, QRS broadening, QTc prolongation, arrhythmia and conduction defects. [16][17][18][19] Selegiline is an irreversible and selective type B inhibitor of monoamine oxidase (MAO-B) enzyme, 20 and inhibits MAO-A in high doses. Selegiline is widely used to treat Parkinson's disease alone or in combination with levodopa and other anti-Parkinson's drugs.…”