Chandigarh: A recent study led by Chandigarh’s Post Graduate Institute of Medical Education and Research (PGI) has identified a potential life-saving treatment for one of the world’s most lethal pesticide poisonings: aluminum phosphide, commonly known as Celphos.The research, published in the international journal, European Review for Medical and Pharmacological Sciences, demonstrates that Intravenous Lipid Emulsion (ILE)—a fat-based solution typically used for hospital nutrition—can reduce the death rate by 40%.Currently, Celphos poisoning carries a 70% mortality rate with no known specific antidote, often claiming the lives of young adults in agrarian regions. Dr Mandeep Bhatia, lead author from PGI’s Department of Internal Medicine, said, “Doctors have been watching helplessly as patients lose their lives because no specific antidote existed.” The inspiration for the study came from anecdotal case reports where patients showed improvement after consuming coconut oil. “The idea emerged from reports where a mixture of coconut oil and sodium bicarbonate was used to neutralise acid and absorb poison in the stomach,” Dr Bhatia explained. “Based on that, we decided to conduct a formal clinical trial.”Aluminum phosphide is a grain fumigant that releases deadly phosphine gas upon ingestion. The randomised pilot clinical trial, involving 98 adult patients, revealed that ILE acts as a “lipid sink”. “Since phosphine gas is highly soluble in fats, the injected lipid emulsion acts like a sponge, soaking up toxins in the bloodstream before they can prevent cells from using oxygen,” Dr Bhatia said.The results of the trial were dramatic. While the death rate in the group receiving standard care was 62%, those who received the lipid emulsion saw mortality drop to 22.9%. Patients treated with ILE showed much faster improvement in blood chemistry, with serum lactate levels dropping significantly and bicarbonate levels increasing, indicating a quicker reversal of life-threatening blood acidity. The survival gains were even more notable in critical cases.For victims whose blood pressure had already collapsed into shock, the survival rate rose from 0% in the standard care group to 50% in the lipid group. Among patients who had consumed highly toxic “fresh” tablets, none survived under standard care, whereas the survival rate reached 71.4% in the lipid group. Even for those with heart muscle damage, survival jumped from a mere 3.1% to 64.3% with the addition of the lipid emulsion.For healthcare providers in rural areas, this study offers a ray of hope. The treatment uses 20% lipid emulsion, which is already a standard medical product, making it a potentially accessible and cost-effective intervention for emergency wards. The injectable drug can be administered by any physician at the primary care centre. “If local doctors in remote areas administer this injection before referring a patient to PGI, the chances of survival will increase manifold,” said Dr Bhatia.
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