The effect of N-acetyl cysteine NAC on aluminum phosphide poisoning inducing cardiovascular toxicity: a case–control studyReportar como inadecuado

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BackgroundAluminum phosphide AlP is a very effective indoor and outdoor pesticide. We investigated the effects of N-acetyl cysteine NAC on the survival time, hemodynamics, and cardiac biochemical parameters at various time intervals in some cases of AlP poisoning.

MethodsThis research was a case–control study to evaluate 63 AlP poisoned patients during 2010–2012. Patients with cardiovascular complications of AlP to be treated with intravenous NAC plus conventional treatment were considered as the case group and compared with patients who did not receive NAC. NAC infusion was administered to the case group at 300 mg-kg for 20 h. The data gathered included age, sex, heart rate, Systolic blood pressure SBP, creatine phosphokinase CPK, creatine kinase MB CK-MB, and ECG at the admission time and 12, 18, and 24 h after admission. Analysis of repeated measures was performed to check the variability of parameters over time.

ResultsThe mean ages in the case and control groups were 26.65 ± 1.06 19–37 years and 28.39 ± 1.11 18–37 years, respectively P = 0.266. Most of the patients were female 56.5%. CK-MB means were significantly different between the two groups, but no differences between the other variables were observed. Also, CK-MB, CPK, heart rate, and systolic blood pressure means became significantly different over time 0, 12, 18, and 24 h in both groups P < 0.001. NAC prevented sharp heart rate fluctuations in AlP patients in the case group. Regarding the outcomes, 17 patients died 10 patients in the control and 7 patients in the case groups. No side-effects of NAC were observed.

ConclusionOur patients could be managed by the positive role of NAC as the biochemical index of cardiotoxicity was found to elevate in both the case and control groups. Therefore, for the management protocol optimization, NAC evaluation should be done in further cases.

KeywordsAluminum phosphide N-acetyl cysteine Pesticide Rice tablet AbbreviationsAlpaluminum phosphide

NACN-acetyl cysteine

CK-MBcreatine kinase MB


SBPsystolic blood pressure

CPKcreatine phosphokinase

ICUIntensive Care Unit

PVCpremature ventricular contraction

MImyocardial infarction

AFatrial fibrillation

VTventricular tachycardia

VFventricular fibrillation



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Autor: Fakhreddin Taghaddosinejad - Esmaeil Farzaneh - Mahdi Ghazanfari-Nasrabad - Nastaran Eizadi-Mood - Morteza Hajihosseini - Omi


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