Indian Journal of Critical Care Medicine Medknow Publications on behalf of the Indian Society of Critical Care Medicine ISSN: 0972-5229 EISSN: 1998-359x Vol. 13, Num. 3, 2009, pp. 171-171

Indian Journal of Critical Care Medicine, Vol. 13, No. 3, July-September, 2009, pp. 171

Letter to the Editor

Aluminum phosphide poisoning

Wiwanitkit Viroj

Wiwanitkit House, Bangkhae, Bangkok- 10160

Correspondence Address:Wiwanitkit House, Bangkhae, Bangkok- 10160
wvrioj@yahoo.com

Code Number: cm09039

PMID: 20040819

DOI: 10.4103/0972-5229.58547

Sir,

I read the recent publication by Jaiswal et al., on aluminium phosphide poisoning with great interest. ^[1] In their work, ^[1] correction of severe metabolic acidosis on patient outcome was studied. Jaiswal et al., noted that "there was significant improvement from 30.36% in the case when only half correction was done, as has been the common practice, to 57.5%, when full correction of metabolic acidosis was done." ^[1] Indeed, aluminium phosphide poisoning is confirmed for induction of severe metabolic acidosis and relates to the high mortality. Khosla et al., noted that "severe metabolic acidosis was common and mortality was high (49%)." ^[2] The correction of metabolic acidosis seems to be the core therapeutic concept for aluminium phosphide poisoning. There is no doubt about the usefulness of this treatment. Several treatments are available at present, including gastric lavage with potassium permanganate solution, oral administration of charcoal and sorbitol suspension, intravenous administration of sodium bicarbonate, magnesium sulphate and calcium gluconate, and oral administration of sodium bicarbonate as well as alternative usage of oral administration of coconut oil. ^[3] No doubt that full correction of metabolic acidosis must be the aim of treatment since there is no reason to leave acidosis within the patient.

References

1.	Jaiswal S, Verma RK, Tewari N. Aluminum phosphide poisoning: Effect of correction of severe metabolic acidosis on patient outcome. Indian J Crit Care Med 2009;13:21-4.  Back to cited text no. 1  [PUBMED]
2.	Khosla SN, Handa R, Khosla P. Aluminium phosphide poisoning. Trop Doct 1992;22:155-7.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.	Shadnia S, Rahimi M, Pajoumand A, Rasouli MH, Abdollahi M. Successful treatment of acute aluminum phosphide poisoning: Possible benefit of coconut oil. Hum Exp Toxicol 2005;24:215-8.  Back to cited text no. 3

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