Comparison between Gastric Lavage with Paraffin Oil versus Coconut Oil in Acute Aluminum Phosphide Poisoning: A Randomized Controlled Clinical Trial

Background: The high mortality incidence of acute aluminum phosphide poisoning (ALP)
poses serious problems for healthcare workers, especially in developing countries. There is no
precise antidote, and the treatment is mainly supportive. As a result, novel therapeutic
approaches must be evaluated to reduce the morbidity and mortality. Aim of the Study:
Evaluation of the safety and efficacy of gastric lavage with paraffin oil versus coconut oil as
adjuvants to sodium bicarbonate 8.4% solution for ALP poisoned patients. Methods: This
double-blinded, parallel-group, randomized trial (Trial ID: NCT04724655) enrolled 60
symptomatic patients of both gender who presented within two hours of ALP exposure. The
patients were randomly allocated into three equal groups (20 patients each). All groups received
the conventional treatment. In paraffin group, patients were subjected to gastric lavage with a
mixture of paraffin oil in addition to sodium bicarbonate 8.4%. In coconut group, patients were
subjected to gastric lavage with a mixture of coconut oil and sodium bicarbonate 8.4%. In the
saline group, patients were subjected to gastric lavage with a mixture isotonic saline added to
sodium bicarbonate. Outcomes were recorded in all groups. Results: The percentage of deaths
among patients who received paraffin and coconut oily substances for gastric lavage were nonsignificantly lower than patients in the saline group. In addition, there was a significant
prolongation of hospital stays with higher survival time in both paraffin and coconut treated
groups than in the saline group (p <0.001). Meanwhile, there was no significant difference
between the paraffin and coconut groups. Furthermore, there were no reported significant
adverse events of paraffin or coconut oil use. Conclusion: Paraffin oil and coconut oil might
give hope to ALP poisoned patients; lowering the need for mechanical ventilation and
significantly improve the survival time in patients who received oily gastric lavage solution than
the saline-based solution with no adverse events
Received in original form: 18 June 2022 Accepted in a final form: 1 September 2022