The Effect of Hyperinsulinemia-Euglycemia on Acute Aluminum Phosphide Poisoning: A Clinical Trial

Background: Aluminum Phosphide toxicity, a common deliberate hazard, often leads to death due to the absence of a specific antidote for treatment. This study aimed to assess the efficacy of the Hyper Insulin Euglycemia protocol combined with vitamin E and N-acetyl cysteine in the treatment of patients with acute Aluminum Phosphide poisoning. Methods: In this incidental prospective clinical trial, 76 individuals with toxicity were enrolled and assigned to two groups: one treatment group receiving glucose, insulin, and potassium administration along with vitamin E and N-Acetyl Cysteine, and one control group primarily managed with supportive treatments. Signs and symptoms at arrival and during hospitalization, complications, and outcomes were recorded and compared between these two groups to identify any potential effects of vitamin E and the protocol for toxicity treatment. Results: This study investigated the mortality and safety of therapy in 76 poisoning patients with an average age of 28. The mortality rate in the treatment group was 26% lower than in the control group (p-value: 0.058). Furthermore, this research observed a significant increase in systolic blood pressure during hospitalization in the treatment group. Regarding pH and bicarbonate levels, the treatment group exhibited less metabolic acidosis. In contrast to the case group, the therapy group s bicarbonate levels significantly increased throughout hospitalization. Conclusion: The use of vitamin E and the protocol, along with symptomatic and supportive treatments, in acute Aluminum Phosphide toxicity among the treatment group in this study resulted in a significant increase in systolic blood pressure, lon ger hospitalization duration, and lower death rates.