Seyed Reza Mousavi - Department of Forensic Medicine and Clinical Toxicology, Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Zeinab Ayoubi - Department of Forensic Medicine and Clinical Toxicology, Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Maryam Vahabzadeh - Department of Forensic Medicine and Clinical Toxicology, Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Lida Jarahi - Department of Community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Khadijeh Abdi Valami - Department of Forensic Medicine and Clinical Toxicology, Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Hamid Reza Rahimi - Department of Medical Genetics and Molecular Medicine, Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Introduction: Aluminum phosphide (AlP) poisoning, commonly known as rice tablet poisoning, is a lethal method of suicide with no known antidotes. Thyroid hormones have inotropic effects that can potentially reverse hemodynamic instability and improve cardiac output. This study investigated the effects of Triiodothyronine (T۳) on the cardiac function of patients with aluminum phosphide poisoning.Methods: In this randomized clinical trial, ۲۴ patients with confirmed ALP poisoning were recruited. The intervention group received T۳ treatment in addition to standard treatment, while the control group received only standard treatment. Demographic variables, cardiac parameters, biochemical markers, and oxidative stress tests were evaluated.Results: The majority of participants were men (۶۰%) in their thirties (intervention: ۳۲±۱۷.۴ years; control: ۳۰±۱۱.۶ years). Following treatment, both systolic and diastolic blood pressures had significantly higher mean differences in the T۳ group compared to the control group (۱۸.۷±۹.۳, P=۰.۰۵ and ۱۴.۱±۵.۹, P=۰.۰۳ respectively). While both groups showed improvement in mean arterial pH, the intervention group exhibited a significantly greater improvement ۱۲ hours after the administration of T۳, which was significantly different from both the baseline and control groups (p=۰.۰۴, ۰.۰۰۹ respectively). Additionally, the intervention group had a lower QRS and QTc interval compared to admission time.Conclusion: Triiodothyronine administration has been shown to maintain a higher range of SBP, control cardiogenic shock, regulate metabolism, improve acidosis and blood pressure, and ultimately enhance recovery in patients with aluminum phosphide poisoning. Furthermore, it may have cardio-protective effects on these patients.

Aluminum phosphide, Phosphine, Poisoning, Triiodothyronine