The possible therapeutic role of intravenous lipid emulsion in acute aluminium phosphide poisoning: a randomized controlled clinical trial.

IF 2.2 4区 医学 Q3 TOXICOLOGY Toxicology Research Pub Date : 2024-06-13 eCollection Date: 2024-06-01 DOI:10.1093/toxres/tfae090
Hafsa Salah Gheat, Manar M Fayed, Fatma M Elgazzar, Eman I Draz, Rabab S El-Kelany
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Abstract

Introduction: Aluminum phosphide (ALP) is a highly toxic rodenticide and the mortality rates caused by it have been demonstrated up to 70-100% in various studies. Unfortunately, there is no specific antidote to manage its toxic effects. This study aimed to assess the biochemical and clinical efficacy and safety of intravenous lipid emulsion as an adjuvant therapy in acute aluminum phosphide poisoning.

Patients and methods: Sixty-four cases with acute ALP poisoning were stratified according to severity by the Poison Severity Score into severe and moderate groups (32 patients each). Patients were then randomly allocated into either receiving intravenous lipid emulsion in addition to the conventional treatment or receiving the conventional treatment only by using block randomization.

Results: Treatment by ILE resulted in a significant improvement in the survival time, the mean arterial blood pressure, arterial blood gases, and a significant reduction in serum lactate levels. The need for intubation and mechanical ventilation was insignificantly lower in the intervention groups compared to control groups. However, the reduction in mortality rate in the patients of intervention groups compared with control groups was found to be non-significant. Intravenous lipid emulsion use in acute ALP poisoning significantly prolonged the survival time, improved the metabolic acidosis, decreased the serum lactate levels and increased the mean arterial blood pressure and hospital stay in the intervention groups. And insignificantly decreased the mortality rate, need of intubation and mechanical ventilation, and the total dose of vasopressors.

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静脉注射脂质乳剂对急性磷化铝中毒的可能治疗作用:随机对照临床试验。
简介:磷化铝(ALP)是一种剧毒杀鼠剂,多项研究表明其死亡率高达 70%-100%。遗憾的是,目前还没有特定的解毒剂来控制其毒性作用。本研究旨在评估静脉注射脂质乳剂作为急性磷化铝中毒辅助疗法的生化、临床疗效和安全性:64例急性磷化铝中毒患者根据中毒严重程度评分分为重度组和中度组(各32例)。然后采用整群随机法将患者随机分配为在常规治疗的基础上接受静脉注射脂质乳剂治疗或仅接受常规治疗:结果:接受静脉注射脂质乳剂治疗后,患者的存活时间、平均动脉血压和动脉血气均有明显改善,血清乳酸水平也显著降低。与对照组相比,干预组对插管和机械通气的需求明显降低。然而,与对照组相比,干预组患者死亡率的降低并不明显。在急性 ALP 中毒中静脉注射脂质乳剂可明显延长干预组患者的存活时间,改善代谢性酸中毒,降低血清乳酸水平,增加平均动脉血压和住院时间。而死亡率、插管和机械通气需求以及血管加压药总剂量的降低并不明显。
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来源期刊
Toxicology Research
Toxicology Research TOXICOLOGY-
CiteScore
3.60
自引率
0.00%
发文量
82
期刊介绍: A multi-disciplinary journal covering the best research in both fundamental and applied aspects of toxicology
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