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Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study

BACKGROUND: N-acetyl cysteine (NAC) is a powerful antioxidant and has been used extensively in the treatment of paracetamol overdose with great success. Aluminum phosphide (ALP) ingestion results in significant oxidative stress. In this study, we evaluated the effects of NAC on mortality in patients...

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Autores principales: Bhalla, Ashish, Jyothinath, P., Singh, Surjit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5752792/
https://www.ncbi.nlm.nih.gov/pubmed/29307964
http://dx.doi.org/10.4103/0972-5229.220744
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author Bhalla, Ashish
Jyothinath, P.
Singh, Surjit
author_facet Bhalla, Ashish
Jyothinath, P.
Singh, Surjit
author_sort Bhalla, Ashish
collection PubMed
description BACKGROUND: N-acetyl cysteine (NAC) is a powerful antioxidant and has been used extensively in the treatment of paracetamol overdose with great success. Aluminum phosphide (ALP) ingestion results in significant oxidative stress. In this study, we evaluated the effects of NAC on mortality in patients with severe ALP poisoning. SUBJECTS AND METHODS: This prospective intervention study was carried out in the emergency medical unit attached to the Nehru Hospital at PGIMER, Chandigarh, over a period of 1 year. All the patients presenting with severe ALP poisoning were randomized into two group. The treatment group received NAC in the dose of 150 mg/kg intravenous over 1 h, followed by 50 mg/kg over 4 h, followed by 100 mg/kg 16 h in 5% dextrose. The placebo group received 5% dextrose. The primary end point was mortality. RESULTS: A total of 50 patients were recruited. The baseline parameters were comparable in both groups. The survivors in the treatment group received 19 g of NAC, but the nonsurvivors received only 12.15 g of NAC. The overall mortality in the study group was 88% with 87.5% mortality in the treatment group and 88.5% in the placebo group. CONCLUSIONS: Antioxidant therapy in the form of NAC in severe ALP poisoning did not confer any survival benefit.
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spelling pubmed-57527922018-01-05 Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study Bhalla, Ashish Jyothinath, P. Singh, Surjit Indian J Crit Care Med Research Article BACKGROUND: N-acetyl cysteine (NAC) is a powerful antioxidant and has been used extensively in the treatment of paracetamol overdose with great success. Aluminum phosphide (ALP) ingestion results in significant oxidative stress. In this study, we evaluated the effects of NAC on mortality in patients with severe ALP poisoning. SUBJECTS AND METHODS: This prospective intervention study was carried out in the emergency medical unit attached to the Nehru Hospital at PGIMER, Chandigarh, over a period of 1 year. All the patients presenting with severe ALP poisoning were randomized into two group. The treatment group received NAC in the dose of 150 mg/kg intravenous over 1 h, followed by 50 mg/kg over 4 h, followed by 100 mg/kg 16 h in 5% dextrose. The placebo group received 5% dextrose. The primary end point was mortality. RESULTS: A total of 50 patients were recruited. The baseline parameters were comparable in both groups. The survivors in the treatment group received 19 g of NAC, but the nonsurvivors received only 12.15 g of NAC. The overall mortality in the study group was 88% with 87.5% mortality in the treatment group and 88.5% in the placebo group. CONCLUSIONS: Antioxidant therapy in the form of NAC in severe ALP poisoning did not confer any survival benefit. Medknow Publications & Media Pvt Ltd 2017-12 /pmc/articles/PMC5752792/ /pubmed/29307964 http://dx.doi.org/10.4103/0972-5229.220744 Text en Copyright: © 2017 Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Research Article
Bhalla, Ashish
Jyothinath, P.
Singh, Surjit
Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study
title Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study
title_full Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study
title_fullStr Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study
title_full_unstemmed Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study
title_short Antioxidant Therapy in Patients with Severe Aluminum Phosphide Poisoning: A Pilot Study
title_sort antioxidant therapy in patients with severe aluminum phosphide poisoning: a pilot study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5752792/
https://www.ncbi.nlm.nih.gov/pubmed/29307964
http://dx.doi.org/10.4103/0972-5229.220744
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