Acetyl-L-Carnitine effect on acute aluminum phosphide poisoning: A randomized control trial

Aluminum phosphide (AlP) is a leading cause of pesticide poisoning worldwide, with the heart being the critical organ most affected by its toxic effects. This randomized controlled clinical trial aimed to evaluate the potential protective effects of acetyl-L-carnitine (ALC) against AlP poisoning. The study involved forty-four patients poisoned with aluminum phosphide, randomly allocated to either the intervention group, which received basic treatment along with a 1g infusion of ALC upon arrival at the hospital and every 8 hours thereafter, or the control group, which received basic treatment alone. The study assessed the association between demographic and poisoning-related factors and mortality during hospital stays in both groups. The results showed that the mortality rate was substantially lower in the ALC group (45.4%, n=10) compared to the non-ALC group (77.3%, n=17), but it was not significant (P = 0.06). Additionally, the length of hospital stay was significantly shorter for patients in the ALC group compared to those in the control group, and after therapeutic intervention, patients in the ALC group exhibited a statistically significant elevation in ejection fraction compared to the control group. Preliminary results suggest that ALC treatment alongside standard care might reduce mortality and hospital stay in AlP-poisoned patients, albeit without detectable side effects. However, these findings are initial and should be approached with caution. They are not definitive, and larger, more comprehensive studies are vital for confirming ALC's efficacy and safety in clinical practice. The potential benefits of ALC in managing AlP poisoning warrant further investigation before widespread clinical application.