Health Condition 1: T608- Toxic effect of other pesticides
Conditions
Interventions
Intervention1: Glucose Insulin Pottasium Infusion in Aluminium phospide poisoning: All patients will receive standard ALP poisoning management as per institutional protocols and GIK protocol regimen.
Sponsors
Dr Rasha Saleem
Eligibility
Inclusion criteria
Inclusion criteria: 1. Age 14 years and above 2. Patients with confirmed or strongly suspected aluminum phosphide ingestion based on history or container or tablet remnants or characteristic garlic or fishy odour or supportive laboratory test such as silver nitrate test 3. Patients classified as unstable aluminum phosphide poisoning defined as any one of the following a. Circulatory collapse with mean arterial pressure less than 65 mmHg after at least 30 mL per kg fluids and requiring vasopressor support b. Respiratory failure requiring non invasive ventilation with impending failure or requiring mechanical ventilation c. Severe metabolic derangement with lactate 4 mmol per L or more or arterial pH less than 7 point 30 d. Life threatening ventricular arrhythmias e. Altered sensorium with Glasgow Coma Scale score 8 or less requiring airway protection 4. Time from ingestion to arrival in the emergency department less than or equal to 24 hours
Exclusion criteria
Exclusion criteria: Known diabetes mellitus, renal or liver disease Co-ingestion of other substances Any patient with confirmed ALP poisoning but is categorised as stable (do not full fullfill criteria for unstable ALP poisoning) Patients receiving prehospital treatment affecting glucose or potassium
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To determine whether the use of GIK infusion as an adjunct to standard supportive care reduces in-hospital mortality in patients presenting with acute Aluminum phosphide poisoning, compared to Standard treated without GIK (historical) within 48 hoursTimepoint: To determine whether the use of GIK infusion as an adjunct to standard supportive care reduces in-hospital 48 hour mortality in patients presenting with acute Aluminum phosphide poisoning, compared to Standard treated without GIK (historical). | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. To assess the prognostic value of Glu-K ratio at presentation in predicting in-hospital mortality and poor outcomes in ALP poisoning.Timepoint: 1st hour;To compare the predictive accuracy of Glu-K ratio with other routinely used prognostic markers, such as serum lactate, and with validated severity scores, including PSS, APACHE II, PGI, and REMS.Timepoint: Glu-K ratio within 1 huour;To evaluate the effect of GIK therapy on hemodynamic parameters, vasopressor requirements, acid-base status, and length of hospital/ICU stayTimepoint: ABG every 6 hours and throughout the length of ICU stay;4. To analyze the timing and duration of GIK administration in relation to survival outcomes.Timepoint: within 4 hours of ingestion or not;To document and evaluate any adverse events associated with GIK therapy, including hypoglycemia and electrolyte disturbances.Timepoint: RBS every hourly and ABG every 6th hourly | — |
Countries
India
Contacts
Public ContactRasha Saleem
AIIMS PATNA
Outcome results
None listed