A promising method for the treatment of aluminum phosphide poisoning: An experimental study in rats

Aluminum phosphide (ALP) poisoning has a high mortality rate. The purpose of this study was to evaluate the efficacy of lipid emulsion (ILE) and N-acetyl cysteine (NAC) in the treatment of aluminum poisoning in the rat model. This experimental study was conducted on thirty-three rats. Six rats in the control group were given oral corn oil and twenty-seven rats in the other groups were orally poisoned using ALP dissolved in corn oil (Control group, ALP group, ALP-NAC group, ALP-ILE group). All the rats were monitored for hemodynamics and ECG parameters. Mixed ANOVA analysis was applied to compare means across groups. Actuarial life table analysis was applied to compare the survival rate of rats. In terms of hemodynamics, ALP group had a significant difference in means of heart rate (HR) and shock index (SI) compared to the control group (P = 0.04; P = 0.00, respectively). The ALP-ILE group had no significant difference in means SBP, HR and SI compared to control group (p=1.00, p= 0.58, p=1.00, respectively). In ALP-NAC group, there was a significant difference in means HR and SI compared to the control group (p=0.01, p= 0.00, respectively). The ALP-NAC group had no significant differences in means of SBP, HR ,and SI compared to ALP group but the ALP-ILE group had significant differences in means of SBP and SI. Considering ECG in ALP, ALP-NAC and ALP-ILE groups, changes in the PR interval and duration of QT were not significant compared to the control group. In the ALP-NAC and ALP-ILE groups had no significant differences in means of QT and PR interval compared to the ALP group.There was a 45% survival rate in the ALP-ILE group at the end of 3rd day. Lipid peroxidation in the ALP and ALP-ILE groups significantly increased in comparison to the control group. The total antioxidant capacity (TAC) in the ALP-ILE group increased significantly compared to the control group but was significantly lower than those treated with NAC. In this study, two therapeutic strategies were compared in the treatment of ALP-poisoning. NAC with antioxidant properties and ILE with lipophilicity property. ILE due to its different osmolarity with intravascular osmolarity improves hemodynamic changes and compensates for the systemic effects of aluminum phosphide