Successful treatment of cardiogenic shock with an intraaortic  balloon pump following aluminium phosphide  poisoning.
Aluminium phosphide (AlP) is a highly toxic pesticide that inhibits cytochrome oxidase c and causes oxidative stress. Death results from refractory cardiogenic shock due to myocardial dysfunction. There is very little information regarding extracorporeal life support in severe AlP poisoning. Although several therapies are available, none are curative. We report on the use of an intra-aortic balloon pump (IABP) in a 24-year-old woman brought to our hospital after an intentional ingestion of a tablet of AlP (3 g), which caused refractory AlP-induced cardiogenic shock and acute respiratory distress syndrome (ARDS). The patient underwent gastric lavage with potassium permanganate, received sodium bicarbonate intravenously, and was admitted to the intensive care unit. Echocardiography at 36 h post ingestion showed a left ventricular ejection fraction (LVEF) of <20 %. An IABP was inserted and the patient’s vital signs stabilised. After eight days, the IABP was removed and on day 20, the patient’s LVEF increased to 50 %. IABP was successfully used and may improve future prognoses for severely poisoned AlP patients with refractory cardiogenic shock. We encourage clinical toxicologists to examine this new treatment.
Omid
O
Mehrpour
Ahmad
A
Amouzeshi
Bita
B
Dadpour
Zohreh
Z
Oghabian
Nasim
N
Zamani
Shahram
S
Amini
Robert S
RS
Hoffman
D000328:Adult; D017607:Aluminum Compounds / Q000506:poisoning*; D005260:Female; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D010575:Pesticides / Q000506:poisoning*; D010720:Phosphines / Q000506:poisoning*; D012770:Shock, Cardiogenic / Q000139:chemically induced* / Q000628:therapy*; D013406:Suicide, Attempted; D055815:Young Adult
D017607:Aluminum Compounds; D010575:Pesticides; D010720:Phosphines; C001864:aluminum phosphide