The effect of hyperinsulinemia-euglycemia on acute aluminum phosphide poisoning: a clinical trial

Mazaheri Tehrani, Bahareh; Toreyhi, Hossein; Jolfaei, Pardis; Soltaninejad, Kambiz; Rahimi, Mitra; Amiri, Hassan; Shadnia, Shahin

doi:10.22038/apjmt.2023.74361.1428

The effect of hyperinsulinemia-euglycemia on acute aluminum phosphide poisoning: a clinical trial

Document Type : Original Article

Authors

Bahareh Mazaheri Tehrani ¹

Hossein Toreyhi ²

Pardis Jolfaei ²

Kambiz Soltaninejad ³

Mitra Rahimi ⁴

Hassan Amiri ⁵

Shahin Shadnia ⁶

¹ Department of Pharmacology & Toxicology, Faculty of Pharmacy ,Pharmaceutical Sciences Branch, Islamic Azad University ,Tehran - Iran (IAUPS )

² Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

³ Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran

⁴ toxicological Research Center, Department of Clinical Toxicology, Shahid Beheshti University of Medical Sciences,Loghman Hakim Hospital, Tehran, Iran.

⁵ Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran

⁶ Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

https://doi.org/10.22038/apjmt.2023.74361.1428

Abstract

Background: Aluminum Phosphide toxicity is a common deliberate toxicity, and due to no specific antidote available for its treatment, most toxicity leads to death. The present study aimed to evaluate the efficacy of Hyper Insulin Euglycemia protocol in combination with vitamin E and N-Acetyl Cysteine in patients with acute ALP poisoning treatment.
Methods: In this incidental prospective clinical trial, 76 individuals with toxicity were enrolled and assigned into two groups: One treatment group undergoing by glucose, insulin, and potassium() administration in combination with vitamin E and N-Acetyl Cysteine, and one control group who were mainly managed by supportive treatments. Signs and symptoms at arrival and during hospitalization, complications, and outcomes were recorded and compared between these two groups to find any possible effect of, vitamin E, and protocol for toxicity treatment.
Results: This study investigated the mortality and safety of therapy in 76 poisoning patients with an average age of 28. The mortality rate in the group was 26% lower than in the control group (p-value: 0.058). Furthermore, this research detected a significant rise in systolic blood pressure during hospitalization in the treatment group. Regarding pH and bicarbonate levels, the group showed less metabolic acidosis. In contrast to the case group, the therapy group's bicarbonate levels significantly increased throughout hospitalization.
Conclusion: Using the, vitamin E, and protocol accompanied by Symptomatic and supportive treatments in acute ALP toxicity among the treatment group of this study resulted in a significant increase in systolic blood pressure, longer hospitalization duration, and lower death rates.

Keywords

aluminum phosphide toxicity

glucose-insulin- potassium

hyper insulin euglycemia

rice tablet

Subjects

Medical Toxicology

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