| Aluminum Phosphide (ALP) poisoning is regarded as fatal; however, it is commonly used in
developing countries. In some countries, such as India and Iran, it is still being used to protect
grain against pests at home. As yet, no known antidote is reported to be effective against ALP
poisoning. ALP acts through blockage of cell respiration, alteration of cell permeability, and
induction of oxidative stress. Some factors can worsen the prognosis of its intoxication, which
include hyperglycemia on admission, ingestion of fresh tablets, cardiac abnormality, especially
Ventricular Tachycardia (VT), severe metabolic acidosis, cardiogenic shock and other types
of shocks, electrolyte disturbances, end-organ damage, and a need for mechanical ventilation.
ALP kills its victims by induction of multi-organ failure.
In this study, we controlled the patient’s VT using MgSO4, electric shock, amiodarone, and
lidocaine. We also encountered the cardiogenic shock using norepinephrine, High-Dose Insulin
(HDI), antioxidants, sodium bicarbonate, and normal saline. Moreover, myocardial ischemia,
recurrent VTs, and adverse cardiac effects were protected via tight control of magnesium and
other electrolytes. |