Comparing the effectiveness of L-carnitine and paraffin oil in acute aluminum phosphide poisoning using predictive biomarkers and scores: A randomized controlled clinical trial.

2023-01-02
Human & experimental toxicology 42
- Walaa G Abdelhamid
- Mahmoud L Sakr
- Olfat E Mostafa
- Dalia Zaafar
- Hanan M Abdelwahab

PubMed: 36592154
DOI: 10.1177/09603271221149650

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 96
Population: 96 individuals with acute AlP poisoning
Methods: randomized, controlled, parallel-group, single-blind clinical study; standard AlP therapy plus either L-carnitine or medicated paraffin oil
Blinding: Single-blind
Duration: 1 year
Funding: Unclear

Aluminum phosphide (AlP) poisoning is a serious medical emergency with a high mortality rate. The absence of an exact antidote for AlP poisoning necessitates the quest for alternative treatment options. The study sought to assess the efficacy of adding L-carnitine or medicated paraffin oil to the conventional approach of treatment employed in cases of acute AlP poisoning. We conducted a 1 year, randomized, controlled, parallel-group, single-blind clinical study. 96 individuals with acute AlP poisoning were randomly assigned to one of three groups. The standard AlP therapy was administered to all groups according to the Poison Control Center guidelines at the Ain-Shams University hospitals. All patients underwent a medical history review, clinical examination, and laboratory tests. The outcomes were assessed. The participants in the study groups had mean ages ranging from 25.6 to 26.3 years. The cases analyzed were evenly distributed between genders, with the majority originating from rural areas. The average delay time varied from 2.9 to 4.2 h. All patients in the study reported ingesting AlP during suicide attempts. 12 hours after admission, many clinical and biochemical data improved in both intervention groups including cytochrome c oxidase, caspase-3, caspase-9, catalase, and superoxide dismutase. The intervention groups required significantly less mechanical ventilation and had a lower mortality rate than the control group. Decontamination with paraffin oil could be advantageous for reducing the severity of AlP poisoning, improving prognosis, and lowering the mortality rate.

Research Insights

L-Carnitine→Improved Catalase Level
12 hours after admission, many clinical and biochemical data improved in both intervention groups including cytochrome c oxidase, caspase-3, caspase-9, catalase, and superoxide dismutase.
Effect
Beneficial
Effect size
Moderate
L-Carnitine→Improved Cytochrome c Oxidase Level
12 hours after admission, many clinical and biochemical data improved in both intervention groups including cytochrome c oxidase, caspase-3, caspase-9, catalase, and superoxide dismutase.
Effect
Beneficial
Effect size
Moderate
L-Carnitine→Improved Superoxide Dismutase Level
12 hours after admission, many clinical and biochemical data improved in both intervention groups including cytochrome c oxidase, caspase-3, caspase-9, catalase, and superoxide dismutase.
Effect
Beneficial
Effect size
Moderate
L-Carnitine→Reduced Caspase-3 Level
12 hours after admission, many clinical and biochemical data improved in both intervention groups including cytochrome c oxidase, caspase-3, caspase-9, catalase, and superoxide dismutase.
Effect
Beneficial
Effect size
Moderate
L-Carnitine→Reduced Caspase-9 Level
12 hours after admission, many clinical and biochemical data improved in both intervention groups including cytochrome c oxidase, caspase-3, caspase-9, catalase, and superoxide dismutase.
Effect
Beneficial
Effect size
Moderate
L-Carnitine→Reduced Mortality Rate
The intervention groups required significantly less mechanical ventilation and had a lower mortality rate than the control group.
Effect
Beneficial
Effect size
Large
L-Carnitine→Reduced Need for Mechanical Ventilation
The intervention groups required significantly less mechanical ventilation and had a lower mortality rate than the control group.
Effect
Beneficial
Effect size
Large