Saeed-Aghebat BEKHEIR, Amir BAGHAEI, Hamed HAGHI-AMINJAN, Maryam BAEERI, Shirin HEKMATIRAD, Anita JAHANPANAH, Omid MEHRPOUR, Mohammad ABDOLAHI
Eurasian Journal of Emergency Medicine - 2026;25(1):332-341
Aluminum phosphide (AlP) is a pesticide widely used by farmers in certain Asian countries for its high efficacy in protecting crops from pests. However, misuse in both intentional and unintentional poisoning cases has raised major public health concerns. Despite extensive research into treatments for AlP poisoning (AlPP), no specific antidote exists, and management remains largely supportive. This review examined successful treatment cases reported in the literature. A targeted search was conducted using the keywords "AlP", "phosphine", "antidote", "case report", and "treatment" in the scientific databases Scopus, Web of Science, and PubMed. The identified treatments include disinfection of the digestive tract (including gastric disinfection); prevention of phosphine gas release; administration of coconut oil and olive oil; magnesium sulfate; thyroid hormones; extracorporeal membrane oxygenation; continuous renal replacement therapy (including continuous veno-venous hemofiltration); high-dose insulin; red blood cell exchange; dihydroxyacetone; and antioxidant therapy. These therapeutic approaches may serve as supportive therapy by reducing the harmful effects of AlP . This article evaluates medications and chemical substances proposed for the targeted treatment of AlPP and examines their protective mechanisms and the primary consequences of their use.
