title: Therapeutic role of hyperinsulinemia/euglycemia in aluminum phosphide poisoning.
abstract: BACKGROUND
  Different protocols have been suggested to treat aluminum phosphide (ALP) poisoning. We aimed to evaluate the possible therapeutic effect of hyperinsulinemia/euglycemia (HIE) in treatment of ALP poisoning.
  
  
  METHODS
  In a prospective interventional study, a total of 88 ALP-poisoned patients were included and assigned into HIE group undergoing glucose/insulin/potassium (GIK) protocol and a control group that was managed by routine conventional treatments. The 2 groups were then compared regarding the signs and symptoms of toxicity and their progression, development of complications, and final outcome to detect the possible effect of GIK protocol on the patients' course of toxicity and outcome.
  
  
  RESULTS
  The 2 groups were similar in terms of demographic characteristics and on-arrival vital signs and lab tests. Using GIK protocol resulted in significantly longer hospital stays (24 vs 60 hours; P < 0.001) and better outcomes (72.7% vs 50% mortality; P = 0.03). Regression analysis showed that GIK duration was an independent variable that could prognosticate mortality (odds ratio [95% confidence interval] = 1.045 [1.004,1.087]). The risk of mortality decreased by 4.5% each hour after initiation of GIK.
  
  
  CONCLUSIONS
  GIK protocol improves the outcome of ALP poisoning and increases the length of hospital stay.
authors: Toxicological Research Center, Department of Clinical Toxicology, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
authors: Hossein
authors: H
authors: Hassanian-Moghaddam
authors: Nasim
authors: N
authors: Zamani
mesh_terms: D000328:Adult; D017607:Aluminum Compounds / Q000506:poisoning*; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000008:administration & dosage*; D006801:Humans; D006946:Hyperinsulinism / Q000503:physiopathology*; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D016017:Odds Ratio; D010720:Phosphines / Q000506:poisoning*; D011041:Poisoning / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D017607:Aluminum Compounds; D001786:Blood Glucose; D007328:Insulin; D010720:Phosphines; C001864:aluminum phosphide; D005947:Glucose