Aluminum phosphide poisoning: Possible role of supportive measures in the absence of specific antidote

Indian J Crit Care Med. 2015 Feb;19(2):109-12. doi: 10.4103/0972-5229.151019.

Abstract

Aluminum phosphide (ALP) poisoning is one of the major causes of suicidal deaths. Toxicity by ALP is caused by the liberation of phosphine gas, which rapidly causes cell hypoxia due to inhibition of oxidative phosphorylation, leading to circulatory failure. Treatment of ALP toxicity is mainly supportive as there is no specific antidote. We recently managed 7 cases of ALP poisoning with severe hemodynamic effects. Patients were treated with supportive measures including gastric lavage with diluted potassium permanganate, coconut oil and sodium-bicarbonate first person account should be avoided in a scientific paper. Intravenous magnesium sulfate, proper hemodynamic monitoring and vasopressors. Four out of 7 survived thus suggesting a role of such supportive measures in the absence of specific antidote for ALP poisoning.

Keywords: Aluminum phosphide; coconut oil; magnesium sulfate; phosphine gas; potassium permanganate.