DMCH & HDHI Doctors use new treatment modality to cure patients from celphos poisoning: A common poisoning in Punjab

Ludhiana, March 14, 2014: Celphos or (Alumninium Phosphate) poisoning commonly used rodenticide for wheat preservation, has always proved to be fatal when young patient with suicidal attempts come to emergency with very low blood pressures and heart failure. The pumping activity of heart is reduced to less than 30% and most of these patients die within 1-3 days with multi-organ and heart failure. No definitive treatment or antidote is available and these patients are managed with supportive palliative care.
According to the recently published studies, poisoning occupies an important place among the unnatural causes of death, next only to road traffic accidents as far as the cause of death is concerned. With the increasingly indiscriminate use of insecticides and pesticides in agriculture, the number of poisoning deaths has increased manifold. The incidence of poisoning is increasing day by day because these poisons are cheap, easily available without any check on their sale. Previously the cases of poisoning were mostly accidental but presently poisons are the commonest mode of committing suicide. In India there is no check on their sale and anybody can purchase it over the counter. This is the main reason for increase in the number of poisoning cases over the past few years. The commonly used poisons these days are organo-phosphorus compounds and aluminium phosphide.
According to Chief Cardiologist-Dr GS Wander, The doctors in department of cardiology, critical care, CVTS Hero DMC Heart Institute in collaboration with department of medicine Dayanand Medical College & Hospital alongwith University of California conceived that these patients with heart failure and shock could be saved by the circulation in body could be supported by an artificial heart (ECMO – Extra Corporeal Membrane Oxygenation) to tide over the phase till the effect of celphos over the heart and rest of body reversed only. The idea of using this new technique was conceived by Dr Bishav Mohan and other doctors of HDHI including of Dr Naved Aslam(Cardiologist), Dr Dr Sarju Ralhan (Cardiac Surgeon), Dr Vivek Gupta (Cardiac Anaesthesist).Dr Bishav Mohan further said that ECMO has been used for the first time in India for treatment of these patients with celphos poisoning and 5 young lives have been saved by this modality which was so far a dream for medical fraternity.
According to Dr Sandeep Puri (Prof & Head of Medicine), ECMO has been used in some centres of country and abroad previously for management of patients with heart failure, cardiogenic shock, respiratory failure, severe flu-HINI infection in respiratory failure. By puncturing the femoral artery and vein through a surgical nick the circulation of body is diverted through artificially created channels into the oxygenator via ECMO to maintain oxygenation of essential tissues of body till the effect of celphos poison weans off. This procedure require high surgical expertise as it is done under very low pressure.
The management of Dayanand Medical College & Hospital and Hero DMC Heart Institute feel pride in introducing this technique to this part of country and foresee that there is a ray of hope for these patients for whom otherwise death was the only answer.