Cardiotoxicity in Acute Zinc Phosphide Intoxicated Patients (A Prospective Study) | ||
| Ain Shams Journal of Forensic Medicine and Clinical Toxicology | ||
| Article 5, Volume 24, Issue 1, January 2015, Pages 44-52 PDF (855.1 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ajfm.2015.18656 | ||
| Authors | ||
| Aya Khater; Nesrine Sarhan | ||
| Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain-Shams University, Cairo, Egypt | ||
| Abstract | ||
| Phosphides are common pesticides widely used as a grain preservative. Zinc phosphide toxicity is a major health problem with a high mortality rate especially in developing countries. Cardiotoxicity is the main cause of death in phosphide poisonings. Aim of study: This prospective study aimed to evaluate the cardiovascular affection among zinc phosphide intoxicated patients admitted to the Poison Control Center, Ain Shams University Hospitals (PCC- ASUH) during the period from 1st June 2013 to 1st June 2014 and to determine factors predicting the outcome of patients with zinc phosphide cardiotoxicity with special reference to determination of serum troponin I. Methods: Clinical characteristics (systolic blood pressure and central venous pressure), laboratory parameters (liver enzymes, renal function, serum electrolytes: (sodium and potassium), random blood sugar, serum bicarbonate and qualitative assessment of cardiac troponin I,electrocardiographic ( ECG) findings and treatment characteristics were all recorded. Results: Cardiotoxicity was evident in 18 patients out of 144 (12.5%) with zinc phosphide intoxication, twelve of them died. Systolic blood pressure was significantly lower among non survivors (60 ± 7 mmHg) compared to survivors (75 ± 5 mmHg). Central venous pressure was elevated in 6 patients, all of them died. Serum cardiac troponin I was positive in 67% (12 patients) and it did not predict mortality. Eight patients out of the 18 patients had dysrhythmias which found to be a predictor of mortality. Conclusion: The statistically significant factors useful in predicting mortality in our study were shock (which required vasoactive drugs), increased central venous pressure and ventricular arrhythmias. | ||
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