Comparative Assessment of the Effects of Hydroxyethyl Starch and Normal Saline on Severe Hypotension in Patients with Aluminum Phosphide Poisoning: A Retrospective Study.

Amin Nakhostin-Ansari,Asieh Mansouri,Davood Soroosh,Mohammad Arefi,Nasrin Barzegari Dahaj,Samaneh Akbarpour,Gholamabbas Kafi,Behnam Behnoush,Orish Ebere Orisakwe

doi:10.1155/2022/4985120

Abstract

Background Aluminum phosphide poisoning is one of the most common forms of poisoning which requires immediate and urgent treatment. Objective This study aimed to compare the efficiency of two solutions, including hydroxyethyl starch and normal saline, in treating hypotension in patients with aluminum phosphide poisoning. Methods This retrospective cohort study was conducted on 35 patients with aluminum phosphide poisoning. We reviewed the profile of 18 patients treated with hydroxyethyl starch and 17 patients treated with normal saline. Within-group and between-group differences in systolic blood pressure before and after treatment were compared using paired t-test and independent t-test, respectively. Results The mean ± standard deviation (SD) age of the subjects in the starch and normal saline groups was 27.06 ± 9.72 and 27.88 ± 9.08, respectively. The levels of blood pressure in the two groups were not significantly different before the treatment; the mean ± SD of systolic blood pressure in the starch and normal saline groups was 72.67 ± 14.49 and 68.59 ± 8.3, respectively (P=0.313). After the treatment, it was significantly increased to 94 ± 24.45 and 85.18 ± 19.9 in the starch group (P=0.001) and the normal saline group (P=0.004), respectively. However, there was no significant difference between the two groups (P=0.245). Only one person survived in each group. Conclusion According to the results of this study, although there was no significant difference between the two groups in terms of their effects on hypotension, these treatments could not prevent mortality.

Highlights

With the scientific name of aluminum phosphide, is a chemical compound commonly used as an active rodenticide and insecticide to protect cereals [1]. e rice tablet available in Iran, with the commercial name of Phostoxin, contains aluminum phosphide as the main active ingredient; in addition, about 55% of the tablet is composed of urea, carbamate, and ammonium. e tablets are packed in cylindrical packs; each contained ten threegram tablets with a dark gray color, and the package is sold at a low price [2–4]
In the agricultural season, there are usually many deliberate cases of poisoning caused by rice tablets
Previous studies have shown that it is highly expected to observe an increase in central venous pressure due to left ventricular hypokinesis, high-dose and highvolume venous fluid administration does not cause severe impairment in these patients. erefore, it is necessary to preserve systolic blood pressure above 80 mmHg by administering dopamine and dobutamine [4]

Summary

Research Article

Comparative Assessment of the Effects of Hydroxyethyl Starch and Normal Saline on Severe Hypotension in Patients with Aluminum Phosphide Poisoning: A Retrospective Study. Amin Nakhostin-Ansari ,1 Gholamabbas Kafi ,2 Mohammad Arefi ,3 Nasrin Barzegari Dahaj ,4 Samaneh Akbarpour ,5,6 Asieh Mansouri ,7 Behnam Behnoush ,2 and Davood Soroosh 8. Received 14 October 2021; Revised 17 December 2021; Accepted 5 February 2022; Published 9 March 2022

Introduction

Results

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