The effects of amiodarone prophylaxis on cardiac dysrhythmia in acute aluminium phosphide poisoning

  • Mohammad-Reza Beyranvand Cardiovascular Department, Shahid Moddarres Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
  • Soleyman Farrokhi Department of Internal Medicine, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
  • Hassan Peyvandi General Surgery Department, Hearing Disorders Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences
  • Kambiz Soltaninejad 4Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization
  • Shahin Shadnia Toxicological Research Center, Excellent Center of Clinical Toxicology, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran
Keywords: AlP, antidysrhythmics, atrial fibrillation, ECG, Holter, rice tablet, ST-segment, toxicity, ventricular fibrillation

Abstract

Cardiovascular toxicity is the most common cause of fatality in the first 24 hours of poisoning with aluminium phosphide (AlP). Most often manifesting itself in cardiac dysrhythmias. The aim of this study was to evaluate the benefits of amiodarone prophylaxis against cardiac dysrhythmia in 46 patients with acute AlP poisoning. They were divided in two groups of 23: one receiving amiodarone and the other not (control). The treatment group received amiodarone prophylaxis in the initial intravenous bolus dose of 150 mg, followed by a drip of 1 mg/min for six hours and then of 0.5 mg/min for eighteen hours. Both groups were Holter-monitored for 24 hours since admission. Save for amiodarone, both groups received the same standard treatment. Amiodarone had a significant beneficial effect in reducing the frequency of ST-segment elevation and ventricular fibrillation plus atrial fibrillation (P=0.02 and P=0.01, respectively), but the groups did not differ significantly in mortality (9 vs 11 patients, respectively). The mean time between ICU admission and death (survival time) was significantly longer in the treatment group (22 vs 10 h, respectively; P=0.03). Regardless its obvious limitations, our study suggests that even though amiodarone alone did not reduce mortality, it may provide enough time for antioxidant therapy to tip the balance in favour of survival and we therefore advocate its prophylactic use within the first 24 h of AlP poisoning.

Published
2019-02-14
How to Cite
1.
Beyranvand M-R, Farrokhi S, Peyvandi H, Soltaninejad K, Shadnia S. The effects of amiodarone prophylaxis on cardiac dysrhythmia in acute aluminium phosphide poisoning. AIHT [Internet]. 14Feb.2019 [cited 18Jun.2019];70(1). Available from: https://arhiv.imi.hr/index.php/arhiv/article/view/986
Section
Original article