Accidental Aluminum Phosphide Intoxication Successfully Treated with Hyperbaric Oxygen Therapy: A Case Report

Author:

Hájek Michal123ORCID,Chmelař Dittmar23ORCID,Tlapák Jakub45,Rybárová Veronika6,Ondra Peter7,Halouzka Vladimír7

Affiliation:

1. Centre of Hyperbaric Medicine, Ostrava City Hospital, 72880 Ostrava, Czech Republic

2. Institute of Laboratory Medicine, Institute of Microbiology, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic

3. Centre for Hyperbaric Medicine of Faculty of Medicine University of Ostrava and Ostrava City Hospital, 70300 Ostrava, Czech Republic

4. The Institute of Aviation Medicine, 16000 Prague, Czech Republic

5. Faculty of Biomedical Engineering, Czech Technical University in Prague, 16000 Prague, Czech Republic

6. Department of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of Medicine, Comenius University, University Hospital, 036 01 Martin, Slovakia

7. Department of Forensic Medicine and Medical Law, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, 77900 Olomouc, Czech Republic

Abstract

The most common pesticide agents are organophosphates and phosphides, aluminum phosphide (ALP) in particular. ALP is a major cause of suicidal poisoning in many countries. In other countries, the problem of accidental, mainly occupational-related, poisoning is also real and actual. Almost two thirds of individuals in poisoning cases have died. This case report describes a case of a patient with accidental ALP intoxication. The origin of the poisoning was the fumigation of stored grain in an agricultural building adjacent to the building in which patient was temporarily housed, while both buildings were connected by an underground corridor, through which the released poison gas penetrated. The case was originally presented by the rescuers as well as healthcare professionals of the local hospital as carbon monoxide intoxication, which has a similar symptomatology as ALP intoxication. The patient was treated comprehensively, including using the HBOT method, which is very unique in the case of phosphine intoxication in human medicine, with an excellent final clinical outcome. This was the first described case of HBOT for ALP intoxication in clinical medicine, although the HBOT indication itself became a coincidence in this case. Further studies must be undertaken to demonstrate the effectiveness of HBOT in treating patients with ALP poisoning.

Funder

Ministry of Health, Czech Republic

Publisher

MDPI AG

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