Abstract
BackgroundAluminum phosphide (AlP) is used as pesticide in some countries for protection of stored grains. Human poisoning with AlP due to suicide attempt or accidental environmental exposure is associated with very high mortality partially due to development of severe metabolic acidosis. Previous studies have shown that hemoglobin has high buffering capacity and erythrocytes can potentially be used for management of metabolic acidosis. The aim of this study was to evaluate the effect of fresh packed red blood cells (RBC) transfusion on survival and cardiovascular function in AlP-poisoned rats.Methodology/Principal findingsRats were poisoned with AlP by gavage. Fresh packed RBC was transfused via tail vein after AlP administration. Acid-base balance, vital signs and mortality was assessed and compared in experimental groups. Infusion of fresh packed RBC (1.5 ml) one hour after AlP (4–15 mg/kg) intoxication was associated with a significant decrease in mortality rate. Packed RBC infusion improved blood pH, HCO3-, Na+ and Ca2+ levels. Plasma troponin level was also reduced and ECG changes were reversed following packed RBC infusion in AlP intoxicated rats.ConclusionsOur results showed that fresh RBC transfusion could ameliorate metabolic acidosis and enhance survival in AlP-poisoned rat. We assume that an increase in pool of RBCs may modulate acid-base balance or potentially chelate AlP-related toxic intermediates via phosphine-hemoglobin interaction.
Highlights
Aluminum phosphide (AlP), known as rice tablet, is used as pesticide in some countries for protection of stored grains [1, 2]
Our results showed that fresh red blood cells (RBC) transfusion could ameliorate metabolic acidosis and enhance survival in AlP-poisoned rat
We assume that an increase in pool of RBCs may modulate acid-base balance or potentially chelate AlP-related toxic intermediates via phosphine-hemoglobin interaction
Summary
Aluminum phosphide (AlP), known as rice tablet, is used as pesticide in some countries for protection of stored grains [1, 2]. Due to accidental exposure or suicide attempts, AlP poisoning is still reported around the globe [3,4,5,6]. In 2001, Alter et al reported a patient who developed metabolic acidosis, progressive heart failure, hypotension and ventricular tachycardia as a result of AlP ingestion [9]. Aluminum phosphide (AlP) is used as pesticide in some countries for protection of stored grains. Human poisoning with AlP due to suicide attempt or accidental environmental exposure is associated with very high mortality partially due to development of severe metabolic acidosis. The aim of this study was to evaluate the effect of fresh packed red blood cells (RBC) transfusion on survival and cardiovascular function in AlP-poisoned rats
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