Abstract
Background Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide. We investigated the effects of N-acetyl cysteine (NAC) on the survival time, hemodynamics, and cardiac biochemical parameters at various time intervals in some cases of AlP poisoning.MethodsThis research was a case–control study to evaluate 63 AlP poisoned patients during 2010–2012. Patients with cardiovascular complications of AlP to be treated with intravenous NAC plus conventional treatment were considered as the case group and compared with patients who did not receive NAC. NAC infusion was administered to the case group at 300 mg/kg for 20 h. The data gathered included age, sex, heart rate, Systolic blood pressure (SBP), creatine phosphokinase (CPK), creatine kinase MB (CK-MB), and ECG at the admission time and 12, 18, and 24 h after admission. Analysis of repeated measures was performed to check the variability of parameters over time.ResultsThe mean ages in the case and control groups were 26.65 ± 1.06 (19–37 years) and 28.39 ± 1.11 (18–37 years), respectively (P = 0.266). Most of the patients were female (56.5%). CK-MB means were significantly different between the two groups, but no differences between the other variables were observed. Also, CK-MB, CPK, heart rate, and systolic blood pressure means became significantly different over time (0, 12, 18, and 24 h) in both groups (P < 0.001). NAC prevented sharp heart rate fluctuations in AlP patients in the case group. Regarding the outcomes, 17 patients died (10 patients in the control and 7 patients in the case groups). No side-effects of NAC were observed.ConclusionOur patients could be managed by the positive role of NAC as the biochemical index of cardiotoxicity was found to elevate in both the case and control groups. Therefore, for the management protocol optimization, NAC evaluation should be done in further cases.
Highlights
Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide
creatine kinase MB (CK-MB), creatine phosphokinase (CPK), heart rate, and systolic blood pressure means were significantly different over time (0, 12, 18, and 24 h) in the case and control groups
The results revealed that CK-MB means were significantly different after 12, 18, and 24 h of admission in comparison with the admission times in both groups (P < 0.001)
Summary
Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide. We investigated the effects of N-acetyl cysteine (NAC) on the survival time, hemodynamics, and cardiac biochemical parameters at various time intervals in some cases of AlP poisoning. Aluminum phosphide (AlP) is a very effective indoor and outdoor pesticide used in some developing countries (Mehrpour and Singh 2010). NAC has been shown to have a protective role against cardiovascular complications by protecting heart cells from the oxidative stress induced by phosphine (Shakeri and Mehrpour 2014). We investigated the effects of NAC on hemodynamics and cardiac biochemical parameters of AlP poisoning cases at various time intervals as well as during the survival time and compared them with those of the control group
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