SynthesisBMC pharmacology & toxicology2023
Efficacy of intravenous N acetylcysteine as an adjuvant therapy in the treatment of acute aluminum phosphide Poisoning: a systematic review and meta-analysis.
Synthesis in BMC pharmacology & toxicology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 11 citations in OpenAlex.
- Successful survival after severe aluminum phosphide poisoning complicated by cardiogenic shock, atrial fibrillation and severe metabolic acidosis: a case report.Journal of medical case reports · 2026Article
- Sulfur-Containing Amino Acid Homeostasis in the Central Nervous System: From Physiology Regulation to Metal-Induced Neurotoxicity.Metabolites · 2026Review
- Reversible Atrial Fibrillation and Cardiogenic Shock Following Acute Aluminum Phosphide Poisoning: A Case Report and Literature Review.Clinical medicine insights. Case reports · 2026Article
- Repurposing landscape of N-acetylcysteine: A scoping review of reviews toward clinical translation.PloS one · 2026Article
- Neurological Manifestations of Aluminum Phosphide (Wheat-Pill/Rice-Pill) Poisoning: A Narrative Review.Cureus · 2025Review
- Considerations on the Management of Zinc Phosphide Toxicity and Proposed Therapeutic Approaches.JNMA; journal of the Nepal Medical Association · 2025Review
- Therapeutic effects of NAC and CoQ10 on aluminium phosphide poisoning as an adjuvant therapy: A Pilot study.Toxicology reports · 2025Article
- Role of serum glucose/potassium ratio in assessing poisoning severity and adverse outcomes in patients with acute aluminum phosphide poisoning.Toxicology reports · 2025Article
- The potential role of N-acetylcysteine as an adjuvant therapy in acute aluminum phosphide poisoning: a randomized clinical trial.Toxicology research · 2025Article
- Aluminum phosphide: Toxicological profiles, health risks, environmental impact, and management protocols: A review.Turkish journal of emergency medicineReview
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAluminum phosphide toxicity is a serious problem in many countries. Unfortunately, there is no specific antidote. N-acetylcysteine has been used in some studies as adjuvant therapy depending on to its antioxidant properties. We hypothesized that IV N-acetylcysteine is effective in reducing mortality rate compared to supportive treatment alone.
methodsWe searched in PubMed, Scopus, Web of Science, and Cochrane Library databases. We only included randomized controlled trials that assessed the efficacy of IV N-acetylcysteine and supportive treatment versus supportive treatment alone in acute aluminum phosphide poisoning. Four investigators independently screened the studies' results and designed the data extraction sheet. The primary and secondary outcomes were mortality and the need for mechanical ventilation rates. Random effects estimators with weights were used to result in the pooled risk ratios.
resultsWe included four randomized controlled trials with 177 patients. 91 patients were distributed in N-acetylcysteine group and 86 patients in the control group. Mortality rates in N-acetylcysteine group and in the control group were 43.95% 66.27% respectively. There was a statistically significant reduction in mortality rate after leave out test (pooled risk ratio, 0.5; 95% confidence interval, 0.32-0.77). Regarding the need for mechanical ventilation, it was measured only in three RCTs. It was assessed in 67 patients in N-acetylcysteine group and 60 patients in the control group. 24 patients were ventilated in N-acetylcysteine group (35.8%) and 29 patients in the control group (48.3%). But it was statistically nonsignificant (pooled risk ratio, 0.71; 95% confidence interval, 0.48-1.04).
conclusionOur meta-analysis revealed that IV N-acetylcysteine may be effective in reducing mortality of severe aluminum phosphide poisoning cases.
trial registrationRegistration number in Prospero CRD42022375344 on 25 NOVEMBER 2022, retrospectively registered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.