Management of celphos poisoning with a novel intervention: A ray of hope in the darkest of clouds

Abstract

Context:Celphos poisoning is one the most common and lethal poisonings with no antidote available till now.Aims:To evaluate the effectiveness of new treatment regimens and interventions in reduction of mortality from the fatal effects of celphos poisoning.Settings and Design:A profile of 33 patients, who got admitted in Intensive Care Unit (ICU) of our institute with alleged intake of celphos pellets, was studied.Materials and Methods:In all the 33 patients with alleged celphos poisoning, extensive gastric lavage was done with a mixture of coconut oil and sodium bicarbonate solution. Strict monitoring, both invasive and non-invasive, was done and symptomatic/supportive treatment was carried out on a patient to patient basis.Statistical Analysis:At the end of the study, all the data were compiled systematically and statistical analysis was carried out using the non-parametric tests and value of P<0.05 was considered significant.Results:Majority of the patients out of the total 33 were young with mean age of 21.86±4.92 and had good educational level. Most of the patients presented clinically with cardiovascular signs and symptoms (58%), followed by respiratory distress (15%) and little higher incidence of multi-organ symptomatology (18%). The mean stay of the patients in ICU was 5.84±1.86 days and the survival rate was 42%.Conclusions:With the treatment regimen we have formulated, we were able to save 42% of our patients and recommend the use of this regimen by all the intensivists and physicians.

A Systematic Review of Aluminium Phosphide Poisoning

“…Bajwa et al (81) recommended extensive gastric lavage with a mixture of sodium bicarbonate solution and coconut oil. The acidic environment of the stomach stimulates the conversion of AlP to phosphine gas, and lavage with sodium bicarbonate can be helpful.…”

A review of the protective role of melatonin during phosphine-induced cardiotoxicity: focus on mitochondrial dysfunction, oxidative stress and apoptosis

“…Unfortunately, administration of exogenous drugs, such as triiodothyronine, vasopressin, iron sucrose, sodium bicarbonate, digoxin, Mg nanoparticle, pralidoxime and N‐acetylcysteine, has not been complete effective therapeutic agents in the case of AlP‐induced cardiotoxicity. The lack of specific antidote and effective supportive care results in high mortality of this poison .…”

“…The main mechanism is believed to be an inhibition of cytochrome c oxidase in the cardiomyocyte mitochondria leading to decreased ATP production and inducing oxidative stress. [5] Unfortunately, administration of exogenous drugs, such as triiodothyronine, [6] vasopressin, [7] iron sucrose, [8] sodium bicarbonate, [9] digoxin, [10] Mg nanoparticle, [11] pralidoxime [12] and N-acetylcysteine, [13,14] has not been complete effective therapeutic agents in the case of AlPinduced cardiotoxicity. The lack of specific antidote and effective supportive care results in high mortality of this poison.…”

Acute peripheral polyneuropathy with multiorgan failure: a diagnostic dilemma

“…Gastric lavage with potassium permanganate or a mixture of coconut oil and sodium bicarbonate solution can be performed; however, there is no consensus agreement on these recommendations 33. There is insufficient data about the efficacy of activated charcoal in settings of acute AlP poisoning.…”