Coconut Oil as an Adjuvant to Magnesium Sulphate Therapy in Acute Aluminum Phosphide Consumption

Objective: Aluminium phosphide (ALP) poisoning is becoming a serious health care problem in India. It has high mortality rate in spite of aggressive intensive management. Aim: This study is designed to assess the effect of prolonged and multiple dose of coconut oil as adjuvant to magnesium sulphate along with supportive therapy in ALP poisoning patients. Method: Prospective randomized clinical trial on ALP poisoning patients admitted in ICU of tertiary care institution. 50 (25 cases in each group) patients of ALP poisoning, confirmed by history and symptoms of ALP poisoning were included in the studied. Group A received multiple dose of coconut oil through ryles tube for 48 hours along with magnesium sulphate (MgSO4 ) infusion, Group B received only MgSO4 infusion with supportive therapy in both the groups. Patients were assessed for number of tablets consumed, delay in reaching hospital, cardiac symptoms, acidosis (Ph), requirement of vasoactive drugs, need of mechanical ventilation and outcome of patients. Results: Mean dose of aluminium phosphate was 1.7gm and delay in reaching hospital ranging from 3.16 - 4.16 hrs (p= 0.036). Cardiac symptoms were lower in Group A (74 %) Comparing to Group B (100%) (p=0.001), Less acidosis seen in Group A Compared to Group B (p=0.001). The mortality rate in Group A (30%) was less comparison to Group B (60%). Conclusion: Multiple dose of coconut oil for 48 hours through ryles tube along with MGSO4 infusion in ALP poisoning patients has beneficial effect on the management and ultimate favourable outcome of the patients