Therapeutic Role of Hyperinsulinemia/euglycemia in Aluminum Phosphide Poisoning

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2016 Aug 7

PMID 27495040

Citations 11

Authors

Hossein Hassanian-Moghaddam

Nasim Zamani

Affiliations

Soon will be listed here.

Abstract

Background: Different protocols have been suggested to treat aluminum phosphide (ALP) poisoning. We aimed to evaluate the possible therapeutic effect of hyperinsulinemia/euglycemia (HIE) in treatment of ALP poisoning.

Methods: In a prospective interventional study, a total of 88 ALP-poisoned patients were included and assigned into HIE group undergoing glucose/insulin/potassium (GIK) protocol and a control group that was managed by routine conventional treatments. The 2 groups were then compared regarding the signs and symptoms of toxicity and their progression, development of complications, and final outcome to detect the possible effect of GIK protocol on the patients' course of toxicity and outcome.

Results: The 2 groups were similar in terms of demographic characteristics and on-arrival vital signs and lab tests. Using GIK protocol resulted in significantly longer hospital stays (24 vs 60 hours; P < 0.001) and better outcomes (72.7% vs 50% mortality; P = 0.03). Regression analysis showed that GIK duration was an independent variable that could prognosticate mortality (odds ratio [95% confidence interval] = 1.045 [1.004,1.087]). The risk of mortality decreased by 4.5% each hour after initiation of GIK.

Conclusion: GIK protocol improves the outcome of ALP poisoning and increases the length of hospital stay.

Citing Articles

Role of serum glucose/potassium ratio in assessing poisoning severity and adverse outcomes in patients with acute aluminum phosphide poisoning.

El-Sarnagawy G, Hafez A, Ghonem M Toxicol Rep. 2025; 14:101947.

PMID: 40026479 PMC: 11872125. DOI: 10.1016/j.toxrep.2025.101947.

Therapeutic Effect of Glucose-Insulin-Potassium (GIK) Infusion Therapy in the Treatment of Acute Aluminum Phosphide Poisoning: An Institutional Study.

Ullah A, Jan S, Shahzad H, Dar M, Khan S, Ahmad K Cureus. 2025; 16(12):e76182.

PMID: 39840180 PMC: 11748338. DOI: 10.7759/cureus.76182.

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as mortality predictors in acute Aluminum phosphide (grain pills) poisoning: clinical insights and risk assessment.

Sharif A, Mabrouk H, Abdo S, Elwy A, Fayed M Toxicol Res (Camb). 2024; 13(6):tfae212.

PMID: 39677490 PMC: 11646068. DOI: 10.1093/toxres/tfae212.

Zinc Phosphide Poisoning: From A to Z.

Juarez-Martinez A, Madrigal-Anaya J, Rodriguez-Torres Y, Dorado-Garcia R, Montes-Ventura D, Jimenez-Ruiz A Toxics. 2023; 11(7).

PMID: 37505522 PMC: 10386637. DOI: 10.3390/toxics11070555.

Hopeful News for Physicians Who Involved in the Treatment of Critical Aluminum Phosphide (Rice Pill) Poisoning Patients.

Vafapour F, Sedaghattalab M Case Rep Crit Care. 2022; 2022:2418341.

PMID: 36313526 PMC: 9613384. DOI: 10.1155/2022/2418341.

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