Successful Management of an Aluminum Phosphide Poisoned Patient Following Ventricular Tachycardia

Aluminum Phosphide (ALP) poisoning is regarded as fatal; however, it is commonly used indeveloping countries. In some countries, such as India and Iran, it is still being used to protectgrain against pests at home. As yet, no known antidote is reported to be effective against ALPpoisoning. ALP acts through blockage of cell respiration, alteration of cell permeability, andinduction of oxidative stress. Some factors can worsen the prognosis of its intoxication, whichinclude hyperglycemia on admission, ingestion of fresh tablets, cardiac abnormality, especiallyVentricular Tachycardia (VT), severe metabolic acidosis, cardiogenic shock and other typesof shocks, electrolyte disturbances, end-organ damage, and a need for mechanical ventilation.ALP kills its victims by induction of multi-organ failure.In this study, we controlled the patient’s VT using MgSO4, electric shock, amiodarone, andlidocaine. We also encountered the cardiogenic shock using norepinephrine, High-Dose Insulin(HDI), antioxidants, sodium bicarbonate, and normal saline. Moreover, myocardial ischemia,recurrent VTs, and adverse cardiac effects were protected via tight control of magnesium andother electrolytes.