Therapeutic role of hyperinsulinemia/euglycemia in aluminum phosphide poisoning.

Abstract:

BACKGROUND:Different protocols have been suggested to treat aluminum phosphide (ALP) poisoning. We aimed to evaluate the possible therapeutic effect of hyperinsulinemia/euglycemia (HIE) in treatment of ALP poisoning. METHODS:In a prospective interventional study, a total of 88 ALP-poisoned patients were included and assigned into HIE group undergoing glucose/insulin/potassium (GIK) protocol and a control group that was managed by routine conventional treatments. The 2 groups were then compared regarding the signs and symptoms of toxicity and their progression, development of complications, and final outcome to detect the possible effect of GIK protocol on the patients' course of toxicity and outcome. RESULTS:The 2 groups were similar in terms of demographic characteristics and on-arrival vital signs and lab tests. Using GIK protocol resulted in significantly longer hospital stays (24 vs 60 hours; P < 0.001) and better outcomes (72.7% vs 50% mortality; P = 0.03). Regression analysis showed that GIK duration was an independent variable that could prognosticate mortality (odds ratio [95% confidence interval] = 1.045 [1.004,1.087]). The risk of mortality decreased by 4.5% each hour after initiation of GIK. CONCLUSION:GIK protocol improves the outcome of ALP poisoning and increases the length of hospital stay.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Hassanian-Moghaddam H,Zamani N

doi

10.1097/MD.0000000000004349

subject

Has Abstract

pub_date

2016-08-01 00:00:00

pages

e4349

issue

31

eissn

0025-7974

issn

1536-5964

pii

00005792-201608020-00026

journal_volume

95

pub_type

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