{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:45:30Z","timestamp":1792806330386,"version":"4.5.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Aluminium phosphide (ALP) poisoning is associated with high mortality, primarily due to severe metabolic acidosis and cardiogenic shock. Effective, targeted interventions are critical to improving outcomes. The present study aimed to compare early intervention using administration of sodium bicarbonate combined with renal replacement therapy (RRT) compared to conventional management to improve survival in patients with ALP poisoning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this observational study, 28 patients with ALP poisoning admitted to the intensive care unit between November 2012 and February 2022 were included (16 retrospectively,12 prospectively). Patients in Group A received gastric decontamination, fluid resuscitation using normal saline upto 20ml\/kg, vasopressors, and inotropes administered as needed based on haemodynamic status. Metabolic acidosis was addressed with 8.4% sodium bicarbonate. An early, aggressive resuscitation protocol was implemented for Group B patients, comprising high-volume sodium bicarbonate (20mL\/kg) administered in place of conventional crystalloids to rapidly elevate arterial potential of hydrogen (pH) above 7.2. Endogenous bicarbonate production was supported with renal replacement therapy (RRT), without the use of extracorporeal membrane oxygenation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Mean age and gender were comparable between the groups. The difference in lactate levels between the groups was statistically significant at 48 hours (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Additionally, pH values were significantly different at 12 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.011*), 24 (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001*), and 48 hours (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). The mortality difference between Group A and Group B was statistically significant with\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.047.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Uncontrolled metabolic acidosis is the central pathophysiological disturbance in ALP poisoning. Early aggressive correction using high-dose sodium bicarbonate and RRT is recommended to enhance survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1285_25","type":"journal-article","created":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T15:00:21Z","timestamp":1776524421000},"page":"570-577","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Early bicarbonate-driven resuscitation and haemodialysis in aluminium phosphide poisoning: Reversing cardiogenic shock"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9836-9466","authenticated-orcid":false,"given":"Narendra","family":"Rungta","sequence":"first","affiliation":[{"name":"Department of Critical Care, Jeevan Rekha Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-8563","authenticated-orcid":false,"given":"Prashant","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B.D. SHARMA PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3592-0061","authenticated-orcid":false,"given":"Kiranpreet","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Pt. B.D. SHARMA PGIMS, Rohtak, Haryana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-1469-7602","authenticated-orcid":false,"given":"Neetika","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Rajasthan Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2803-2607","authenticated-orcid":false,"given":"Neeru","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Jeevan Rekha Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9354-7990","authenticated-orcid":false,"given":"Komal","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Rajasthan Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2857-8925","authenticated-orcid":false,"given":"Sumit","family":"Charan","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Rajasthan Hospital, Jaipur, Rajasthan, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,20]]},"reference":[{"key":"R1-20260418","first-page":"149","article-title":"Trends of acute poisoning in South Karnataka","volume":"3","author":"Unnikrishnan","year":"2005","journal-title":"Kathmandu Univ Med J"},{"key":"R3-20260418","first-page":"84","article-title":"Clinical profile and outcome of poisoning in ICU","volume":"18","author":"Muley","year":"2014","journal-title":"Indian J Crit Care Med"},{"key":"R4-20260418","first-page":"247","article-title":"Management of organophosphate poisoning","volume":"51","author":"Wadia","year":"2003","journal-title":"Neurol 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