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Supportive Measures in Treatment of Aluminum Phosphide Poisoning

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ClinicalTrials.gov Identifier: NCT03879356
Recruitment Status : Completed
First Posted : March 18, 2019
Last Update Posted : March 18, 2019
Sponsor:
Information provided by (Responsible Party):
MKMAbdelrahim, Assiut University

Brief Summary:
Aluminum phosphide poisoning (ALP) is a global public health problem, and self-poisoning accounts for one-third of the world's suicide rate. In fact, in some parts of developing countries, pesticide poisoning causes more deaths than infection. ALP is very common in our government and the prognosis of the cases is usually so bad. Toxicity by ALP is caused by the liberation of phosphine gas, which causes cell hypoxia due to inhibition of oxidative phosphorylation leading to circulatory failure.

Condition or disease Intervention/treatment Phase
Detection of Different Prognostic Factors and Their Relation With the Outcome Using New Protocol to Prove the Role of N-acetyl Cysteine and Adequate Supportive Measures in Aluminum Phosphide Poisoning Drug: N-acetyl cysteine Phase 4

Detailed Description:

Aluminum phosphide poisoning is a major problem, accounting for many Emergency Unit visits and hospitalization, the incidence of aluminum phosphide poisoning increasing in the last few years.

ALP is used as pesticides for many years to protect grains in stores and during its transportation. The availability of these tablets and their low cost make it an easy and common method of suicide in our country with the increasing incidence of social and financial problems that face the youth.

In management, the main objective is to provide effective oxygenation, ventilation, and circulation until phosphine is excreted. All patients of severe ALP poisoning require continuous invasive hemodynamic monitoring and early resuscitation with fluid and vasoactive agents. N- acetylcysteine as an antioxidant and cytoprotective agent reduces myocardial oxidative injury and increase survival time. Magnesium sulfate helps in scavenging free radicals through glutathione (GSH) recovery hence is effective as a parenteral antioxidant in this poisoning as well as has been tried for its general membrane stabilizing effect in cardiac cells .

Death after 24 hours occurs usually owing to shock, cardiac arrhythmia, metabolic acidosis, and acute respiratory distress syndrome.


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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 44 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Supportive Measures in Treatment of Aluminum Phosphide Poisoning as a Trial to Reduce Mortality at Assiut University Hospital
Actual Study Start Date : January 1, 2016
Actual Primary Completion Date : June 30, 2016
Actual Study Completion Date : March 14, 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Poisoning

Arm Intervention/treatment
Aluminum phosphide patients
effect of N-acetyl cysteine and supportive measures in outcome of aluminum phosphide poisoning cases
Drug: N-acetyl cysteine
effect of N-acetyl cysteine in Aluminum phosphide poisoning patients




Primary Outcome Measures :
  1. mortality rate comparison [ Time Frame: 3 days ]
    comparison of mortality rate using the New protocol and previous mortality rate from archive records

  2. hospital stay [ Time Frame: 3 days ]
    number of days the patient stayed at hospital



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • All the cases with the primary diagnosis of Aluminum phosphide toxicity will be included in the study.
  • Willing and able to comply with the study procedures and provide written informed consent to participate in the study.

Exclusion Criteria:

  • Patients with a history of any chronic disease (renal and hepatic).
  • Patients refuse to participate in the study.
  • Aged less than 18 years

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Responsible Party: MKMAbdelrahim, assistant lecturer, Assiut University
ClinicalTrials.gov Identifier: NCT03879356     History of Changes
Other Study ID Numbers: AluminumPhosphideAssiut
First Posted: March 18, 2019    Key Record Dates
Last Update Posted: March 18, 2019
Last Verified: March 2019

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by MKMAbdelrahim, Assiut University:
Aluminum phosphide
N-acetylcystein
Assiut
prognostic factors
Additional relevant MeSH terms:
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Poisoning
Chemically-Induced Disorders
Acetylcysteine
N-monoacetylcystine
Antiviral Agents
Anti-Infective Agents
Expectorants
Respiratory System Agents
Free Radical Scavengers
Antioxidants
Molecular Mechanisms of Pharmacological Action
Protective Agents
Physiological Effects of Drugs
Antidotes