Citation

Farrar RA, B Justus A, Masurkar VA, Garrett PM. Anaesth. Intensive Care 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Australian Society of Anaesthetists, Publisher Australasian Medical Publishing)

DOI

10.1177/0310057X211047603

PMID

34871510

Abstract

Phosphine poisoning is responsible for hundreds of thousands of deaths per year in countries where access to this pesticide is unrestricted. Metal phosphides release phosphine gas on contact with moisture, and ingestion of these tablets most often results in death despite intensive support. A 36-year-old woman presented to a regional hospital after ingesting multiple aluminium phosphide pesticide tablets and rapidly developed severe cardiogenic shock. In this case, serendipitous access to an untested Extracorporeal Membrane Oxygenation (ECMO) service of a regional hospital effected a successful rescue and prevented the predicted death. We discuss the toxicology, management and the evidence for and against using ECMO in this acute poisoning.

Language: en

Keywords

shock; Aluminium phosphide; cardiogenic; drug overdose; extracorporeal membrane oxygenation; phosphine; poisons