HIGH-DOSE INSULIN IS A GOOD OPTIONAL TREATMENT FOR ALUMINUM PHOSPHIDE POISONING: A LONGITUDINAL STUDY
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Keywords
Aluminum phosphide, glucose/insulin/potassium, hyperinsulinemia-euglycemia therapy, pesticide, poisoning
Abstract
Background: The poisoning caused by aluminum phosphide is a critical medical emergency that necessitates immediate and suitable treatment. Recently, the use of high doses of insulin has been suggested in the treatment of this poisoning. We conducted a study to examine how effective various insulin doses are in treating aluminum phosphide poisoning.
Material and Method: This was a descriptive and analytical study on patients poisoned with Aluminum phosphide hospitalized in the ICU department of Loghman Hakim Hospital in 2022. High dose insulin (HDI) protocol was used. Systolic and diastolic blood pressure, urine output, pH, bicarbonate, blood carbon dioxide pressure (PCO2), and ejection fraction (EF) were measured during treatment. Data were analyzed by SPSS software.
Results: The study included 66 men (65.3%) and 35 women (34.7%). The average age of the participants was 32.99±11.45 years. Insulin administration has an inverse correlation with blood PH level, with a 1mIU increase resulting in a 0.31 decrease in PH level. Additionally, there is a significant association between insulin and systolic blood pressure, with a 1IU increase causing a 0.02 mmHg rise in blood pressure. HCO3 level, PCO2, systolic and diastolic blood pressure were significantly higher during the final measurement compared to the time of arrival in patients. The mortality rate was 61.4%. Out of the total cases, 93 (92.1%) were intubated.
Conclusion: High-dose insulin protocol may improve blood pressure, cardiac function, and blood bicarbonate levels in rice tablet poisoning patients.
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Nasrin Khakpoornia
Toxicological Research Center, Clinical Toxicology Department, Excellence Center of Clinical Toxicology, Loghman Hakim University Hospital Poison Center, Shahid Beheshti University of Medical Sciences, Tehran-Iran
Babak Mostafazadeh
Toxicological Research Center, Clinical Toxicology Department, Excellence Center of Clinical Toxicology, Loghman Hakim University Hospital Poison Center, Shahid Beheshti University of Medical Sciences, Tehran-Iran
Shahin Shadnia
Toxicological Research Center, Clinical Toxicology Department, Excellence Center of Clinical Toxicology, Loghman Hakim University Hospital Poison Center, Shahid Beheshti University of Medical Sciences, Tehran-Iran
Mitra Rahimi
Toxicological Research Center, Clinical Toxicology Department, Excellence Center of Clinical Toxicology, Loghman Hakim University Hospital Poison Center, Shahid Beheshti University of Medical Sciences, Tehran-Iran
Peyman Erfan Talab Evini
Toxicological Research Center, Clinical Toxicology Department, Excellence Center of Clinical Toxicology, Loghman Hakim University Hospital Poison Center, Shahid Beheshti University of Medical Sciences, Tehran-Iran
Maral Ramezani
Department of Pharmacology, School of Medicine, Arak University of Medical Sciences, Arak, Iran