N-acetylcysteine Use in Treatment of Acute Aluminium Phosphide Poisoning: Systematic Review and Meta-Analysis
Hussien, S., Al Teftazany, E., Hagras, A., Elhelaly, H., Abdelhamed, W. (2023). N-acetylcysteine Use in Treatment of Acute Aluminium Phosphide Poisoning: Systematic Review and Meta-Analysis. EKB Journal Management System, 41(2), 50-62. doi: 10.21608/ajfm.2023.310229
Salwa Hussien; Enas Al Teftazany; Abeer Hagras; Hend Elhelaly; Walaa Abdelhamed. "N-acetylcysteine Use in Treatment of Acute Aluminium Phosphide Poisoning: Systematic Review and Meta-Analysis". EKB Journal Management System, 41, 2, 2023, 50-62. doi: 10.21608/ajfm.2023.310229
Hussien, S., Al Teftazany, E., Hagras, A., Elhelaly, H., Abdelhamed, W. (2023). 'N-acetylcysteine Use in Treatment of Acute Aluminium Phosphide Poisoning: Systematic Review and Meta-Analysis', EKB Journal Management System, 41(2), pp. 50-62. doi: 10.21608/ajfm.2023.310229
Hussien, S., Al Teftazany, E., Hagras, A., Elhelaly, H., Abdelhamed, W. N-acetylcysteine Use in Treatment of Acute Aluminium Phosphide Poisoning: Systematic Review and Meta-Analysis. EKB Journal Management System, 2023; 41(2): 50-62. doi: 10.21608/ajfm.2023.310229

N-acetylcysteine Use in Treatment of Acute Aluminium Phosphide Poisoning: Systematic Review and Meta-Analysis

Ain Shams Journal of Forensic Medicine and Clinical Toxicology
Volume 41, Issue 2, July 2023, Page 50-62  XML PDF (2.21 MB)
Document Type: Original Article
DOI: 10.21608/ajfm.2023.310229
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Authors
Salwa Hussien1; Enas Al Teftazany2; Abeer Hagras3; Hend Elhelaly2; Walaa Abdelhamed2
1Al khazendarah general hospital, Cairo, Egypt.
2Department of Forensic Medicine and Clinical Toxicology,Faculty of Medicine, Ain Shams University, Egypt.
3Department of forensic medicine and clinical toxicology, Faculty of Medicine, Suez Canal University. Egypt.
Abstract
Background: Aluminum phosphide (AlP) is a popular used rodenticide. It inhibits oxidative
phosphorylation, and causes depletion of glutathione, resulting in cellular wall dysfunction. Nacetylcysteine (NAC) is a glutathione precursor that would be effective in treatment of AlP
poisoning. Aim of the work: Provide evidence based systematic review about role of NAC in
treatment of AlP poisoning which may help in developing clear guidelines for treatment of such
lethal poisoning. Methodology: We followed PRISMA guidelines during preparation of this
study. PubMed, EKB, ScienceDirect and Cochrane CENTRAL were searched to identify the
published literature from inception to June 2022. In addition, we searched for ongoing studies,
reference lists for additional studies. We included randomized cotrolled trials (RCTs) and
observational studies (OSs) published in English, those fulfilling inclusion criteria. Results : The
study included four RCTs and two OSs with total 286 participants. The current study revealed
that there was a significant reduction in mortality rate (OR 0.38, 95% CI [0,23 to 0.66]) and
duration of hospital stay in survivors (SMD -1.73 days, 95% CI [-2.35, -01.11]) as well as a
significant increase in survival time in non survivors in patients who received NAC, compared
with those who did not receive NAC (SMD 0.87 day, 95% CI [0.37, 1.37]). There was no
significant difference between NAC and control groups regarding the need for mechanical
ventilation (OR 0.51, 95% CI [0,23 to 1.10]). Conclusion: N-acetylcysteine in treatment of
acute AlP poisoning can reduce the mortality rate and duration of hospital stay in survivors and
increase survival time.
Received in original form: 28 March 2023 Accepted in a final form: 16 July 2023
Keywords
Aluminium phosphide; Meta-analysis; N-acetylcysteine; poisoning, randomized controlled trials; Systematic review
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