Metal phosphide poisoning in a disaster-stricken area. Can early hemodialysis improve outcomes?

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Hemodialysis International Pub Date : 2024-06-27 DOI:10.1111/hdi.13168

Najjar Abdo, Sekkarie Mohamed, Valerie Luyckx, Alabdullah Mohammad, Sulaiman Abdu el Rahman, Kuhn Christine, Jetter Alexander, Hajj Nasan Khaled, Murad Lina, Rifai Ahmad Oussama, Sami Alasfar, AlhajHusain Ahmad

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Abstract

Background

Phosphide metal poisoning results in tens of thousands of fatalities per year worldwide. The mortality in critically ill patients often exceeds 50%. The available treatment is supportive and there is no antidote. Dialysis is recommended to treat advanced complications but has not been prescribed early in the process. In this study we report our experience in using dialysis in the early hours of presentation of the patients and suggest it can favorably improve the prognosis. We also draw attention to the risk of suicide under conditions of chronic conflict such as those in northwestern Syria, and to the lack of necessary mental health support for patients after suicide attempts.

Methods

Retrospective review of records of patients poisoned with aluminum phosphide and admitted to critical care facilities in northwestern Syria between July 2022 and June 2023.

Results

During the observation period 16 cases were encountered. Suicide was the reason of the poisoning in 15 patients, the median patient age was 18 years and over two thirds of the patients were female. Early dialysis was used in 11 patients who were critically ill and their mortality rate was 18%.

Conclusions

Phosphide metal poisoning is common in the disasters stricken area of northwestern Syria. Most cases are suicidal and impact young females. Early dialytic interventions may favorably impact the outcomes.

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受灾地区的磷化氢金属中毒。早期血液透析能否改善预后？

背景：全世界每年有数万人死于磷化氢金属中毒。重症患者的死亡率往往超过 50%。现有的治疗是支持性的，没有解毒剂。建议采用透析治疗晚期并发症，但在治疗过程的早期并不采用这种方法。在本研究中，我们报告了在患者发病早期使用透析的经验，并建议透析可有效改善预后。我们还提请大家注意在叙利亚西北部等长期冲突条件下的自杀风险，以及自杀未遂患者缺乏必要的心理健康支持的问题：方法：回顾性审查 2022 年 7 月至 2023 年 6 月期间叙利亚西北部重症监护机构收治的磷化铝中毒患者的记录：结果：观察期间共发现16例中毒病例。15 名患者的中毒原因是自杀，患者年龄中位数为 18 岁，超过三分之二的患者为女性。11名病情危重的患者接受了早期透析，死亡率为18%：结论：磷化氢金属中毒在叙利亚西北部受灾地区很常见。大多数病例为自杀，且多为年轻女性。早期透析干预可能会对治疗效果产生有利影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hemodialysis International UROLOGY & NEPHROLOGY-

CiteScore

2.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Hemodialysis International was originally an annual publication containing the Proceedings of the International Symposium on Hemodialysis held in conjunction with the Annual Dialysis Conference. Since 2003, Hemodialysis International is published quarterly and contains original papers on clinical and experimental topics related to dialysis in addition to the Annual Dialysis Conference supplement. This journal is a must-have for nephrologists, nurses, and technicians worldwide. Quarterly issues of Hemodialysis International are included with your membership to the International Society for Hemodialysis. The journal contains original articles, review articles, and commentary to keep readers completely updated in the field of hemodialysis. Edited by international and multidisciplinary experts, Hemodialysis International disseminates critical information in the field.