A randomized, single-blinded, placebo-controlled trial was conducted in Africa to evaluate the treatment of patients with aluminum phosphide poisoning. All patients received standard treatment, including primary resuscitation (airway, breathing, and circulation), intravenous fluids, vasopressors (norepinephrine), gastric decontamination (with sodium bicarbonate and activated charcoal at a dose of 1 g/kg), and treatment of metabolic acidosis with intravenous sodium bicarbonate. The death rate in the control group (standard treatment) was 96.3%The addition of what other treatment resulted in a reduction in death to 64.8%?
A bolus of 1 unit/kg of regular human insulin followed by an intravenous infusion of 0.2 to 0.5 units/kg/h combined with euglycemia treatment with dextrose was associated with a lower death rate.
Adel, B., Elgharbawy, N. M., Shahin, M. M., Abo-Elfadl, A. A., & Saad, K. M. (2023). Insulin-euglycemia therapy in acute aluminum phosphide poisoning: a randomized clinical trial. Clinical Toxicology, 61(12), 1032–1039. https://doi.org/10.1080/15563650.2023.2279495
Contributed by Kristine Nanagas, MD