Hájek Michal, Chmelař Dittmar, Tlapák Jakub, Rybárová Veronika, Ondra Peter, Halouzka Vladimír
Centre of Hyperbaric Medicine, Ostrava City Hospital, 72880 Ostrava, Czech Republic.
Institute of Laboratory Medicine, Institute of Microbiology, Faculty of Medicine, University of Ostrava, 70300 Ostrava, Czech Republic.
Toxics. 2024 Apr 5;12(4):272. doi: 10.3390/toxics12040272.
The most common pesticide agents are organophosphates and phosphides, aluminum phosphide (ALP) in particular. ALP is a major cause of suicidal poisoning in many countries. In other countries, the problem of accidental, mainly occupational-related, poisoning is also real and actual. Almost two thirds of individuals in poisoning cases have died. This case report describes a case of a patient with accidental ALP intoxication. The origin of the poisoning was the fumigation of stored grain in an agricultural building adjacent to the building in which patient was temporarily housed, while both buildings were connected by an underground corridor, through which the released poison gas penetrated. The case was originally presented by the rescuers as well as healthcare professionals of the local hospital as carbon monoxide intoxication, which has a similar symptomatology as ALP intoxication. The patient was treated comprehensively, including using the HBOT method, which is very unique in the case of phosphine intoxication in human medicine, with an excellent final clinical outcome. This was the first described case of HBOT for ALP intoxication in clinical medicine, although the HBOT indication itself became a coincidence in this case. Further studies must be undertaken to demonstrate the effectiveness of HBOT in treating patients with ALP poisoning.
最常见的农药制剂是有机磷酸酯和磷化物，尤其是磷化铝（ALP）。在许多国家，ALP是自杀性中毒的主要原因。在其他国家，意外中毒问题，主要是与职业相关的中毒问题，也是真实存在的。中毒病例中近三分之二的人已经死亡。本病例报告描述了一例意外ALP中毒患者。中毒的源头是对与患者临时居住建筑相邻的农业建筑内储存谷物进行熏蒸，而这两座建筑通过一条地下走廊相连，释放出的毒气由此渗透进来。该病例最初被救援人员以及当地医院的医护人员诊断为一氧化碳中毒，其症状与ALP中毒相似。患者接受了全面治疗，包括采用高压氧疗法（HBOT），这在人类医学中治疗磷化氢中毒的案例中非常独特，最终临床效果极佳。这是临床医学中首次描述的HBOT治疗ALP中毒的病例，尽管在该病例中HBOT的应用是个巧合。必须进行进一步研究以证明HBOT治疗ALP中毒患者的有效性。
