Triiodothyronine Mitigates Cardiac Dysfunction in Aluminum Phosphide Poisoning: Findings from a Randomized Clinical Trial

Aluminum phosphide (AlP) poisoning, commonly known as rice tablet poisoning, is a lethal method of suicide with no known antidotes. Thyroid hormones have inotropic effects that can potentially reverse hemodynamic instability and improve cardiac output. This study investigated the effects of Triiodothyronine (T3) on the cardiac function of patients with aluminum phosphide poisoning. In this randomized clinical trial, 24 patients with confirmed ALP poisoning were recruited. The intervention group received T3 treatment in addition to standard treatment, while the control group received only standard treatment. Demographic variables, cardiac parameters, biochemical markers, and oxidative stress tests were evaluated. The majority of participants were men (60%) in their thirties (intervention: 32±17.4 years; control: 30±11.6 years). Following treatment, both systolic and diastolic blood pressures had significantly higher mean differences in the T3 group compared to the control group (18.7±9.3, P=0.05 and 14.1±5.9, P=0.03 respectively). While both groups showed improvement in mean arterial pH, the intervention group exhibited a significantly greater improvement 12 hours after the administration of T3, which was significantly different from both the baseline and control groups (p=0.04, 0.009 respectively). Additionally, the intervention group had a lower QRS and QTc interval compared to admission time. Triiodothyronine administration has been shown to maintain a higher range of SBP, control cardiogenic shock, regulate metabolism, improve acidosis and blood pressure, and ultimately enhance recovery in patients with aluminum phosphide poisoning. Furthermore, it may have cardio-protective effects on these patients.