Introduction: We aim to discuss the case of a patient with aluminum phosphide (AP) poisoning in a suicide attempt and who was successfully treated with continuous veno-venous hemofiltration (CVVH).
Case Report: A-24-year old lady was admitted to a hospital with the complaints of dizziness, numbness in the face, and nausea and vomiting after taking two tablets of AP. She was transferred to our emergency clinic 10 h later because of persistent hypotension and metabolic acidosis. Her Glasgow Coma Scale score was 13 on admission. Her vital signs were as follows: blood pressure, 80/50 mmHg; pulse rate, 128/min; pulse oximetry, 90%; and respiration rate, 26/min. Her laboratory tests revealed the following: pH, 7.13; bicarbonate level, 10.1 mmol/L; and serum lactate level, 10.2 mmol/L. Other blood test results were normal. CVVH (Prismaflex hemofiltration set M150) was started in the intensive care unit because hypotension and metabolic acidosis were persistent; oliguria was added despite fluid resuscitation and inotrope infusion. Hemofiltration was continued until the 32nd hour when blood pressure and blood gas levels returned to normal. She was discharged healthy on the 4th day of hospitalization.
Conclusion: We suggest the utilization of CVVH in the early stages of AP poisoning before the development of multiple organ failure because AP causes metabolic acidosis and hypotension resistant to medical treatment.
Keywords: Aluminum phosphide, continuous veno-venous hemofiltration, poisoning