Effectiveness of Plasmapheresis in the Treatment and Clinical Outcome of Patients with Aluminum Phosphide Poisoning: A Randomized Controlled Clinical Trial

Abstract

Background: Nowadays, therapeutic plasma exchange (TPE) is considered a novel and promising treatment in cases of poisoning. However, few studies have been conducted on the use of TPE as a treatment in various toxicity cases, especially aluminum phosphide (AlP) poisoning. Therefore, the present study aimed to investigate the efficacy of plasmapheresis in the treatment and clinical outcome of patients with AlP poisoning. Methods: We conducted this randomized controlled clinical trial on 80 patients poisoned with AlP. The control patients (n=58) received only the routine treatment, whereas those in the experimental group (n=22) underwent plasmapheresis in addition to the routine treatment. The plasmapheresis was given to these patients immediately after they had received the routine treatment, within the first six hours of their hospital admission. Results: The study results revealed that the mean hematocrit level in the plasmapheresis group (34.31±3.31) was significantly lower than that of patients in the control group (38.05±4.80) 12 h after the plasmapheresis treatment (P=0.046). Moreover, there were six (27.3) and 14 (24.1) cases of mortality in the plasmapheresis group and the control group, respectively. There was no significant difference in the mortality rates between the two groups (P=0.778). Conclusion: Based on the results of this study, plasmapheresis had a significant effect on increasing the blood HCO3 level within 12 h after the intervention. Therefore, it had a significant role in reducing the resultant acidosis in patients with AlP poisoning; however, this effect did not reduce the mortality rate after plasmapheresis. © 2024 Arak University of Medical Sciences. All rights reserved.