Table 1 The summary of included studies and baseline characteristics of participants

Tehrani, H. et al. 2013

Iran

37(22 in intervention and 15 in control)

Acute aluminum phosphide-intoxicated patients with no history of diabetes mellitus, cardiovascular, respiratory,

renal and hepatic failure, and no medical management for

aluminum phosphide poisoning in any medical center before.

admission

NAC

(140 mg/Kg/IV infusion as a loading dose and 70 mg/Kg/IV infusion every 4 h up to 17 doses)

23.5 ± 7.8

24.7 ± 6.4

M/F29.7%/29.7%

M/F21.6%/18.9%

93.7 ± 17.8

87.3 ± 13.6

88.7 ± 17.1

94.6 ± 21.1

On admission:

195.7 ± 67.4

139 ± 28.2

24 h

after admission

174.6 ± 48.9

149.6 ± 35.2

On admission

11.4 ± 2.2

13.3 ± 2.5

24 h

after admission

12.8 ± 5.7

17.3 ± 5.6

NA

NA

Intervention group: 36% (8 out of 22)

Control group: 60% (9 out of 15)

Intervention group: 45.4% (10 out of 22)

Control group: 73.3% (11 out of 15)

2.7 ± 1.8 days

8.5 ± 8.2 days

Bhalla A. et al. 2017

India

50(24 in intervention and 26 in control)

All the

patients presenting to emergency outpatient department with

alleged history of ingestion of ALP was screened and those.

with shock were eligible

NAC in the dose of 150 mg/kg intravenous over 1 h,

followed by 50 mg/kg over 4 h, followed by 100 mg/kg 16 h in 5% dextrose

< 30 years:24%

40%

> 30 years:24%

12%

M/F38%/10%

M/F32%/20%

77.52 ± 8.59

74.15 ± 9.2

134.015 ± 14.2

137.91 ± 16.99

NA

NA

NA

NA

NA

NA

Intervention group: 87.5% (21 out of 24)

Control group: 88.5% (23 out of 26)

Data not available.

Emam et al. − 2020

Egypt

60 (30 in intervention and 30in control)

Subjects (aged 12 years or older) with

symptomatic acute ALP poisoning and a history

of rice tablets ingestion presented within 6

 h from exposure with no previous medical

treatment for phosphide intoxication in any

medical center prior to admission were included

Dose 1: 150 mg/kg IV, mixed in 200 mL of D5W and infused over 1 h. Dose 2: 50 mg/kg IV, mixed in 500 mL D5W

and infused over 4 h. Dose 3: 100 mg/kg IV, mixed in 1000 mL.

D5W and infused over 16 h.

24.4 ± 10.5

24.4 ± 9.66

M/F18.3%/31.6%

M/F18.3%/31.6%

92.16 ± 21.9

94.83 ± 21.1

104.57 ± 20.5

104.27 ± 20.5

NA

NA

NA

NA

NA

NA

Intervention group: 20% (6 out of 30)

Control group: 43.3% (13 out of 30)

Intervention group: 23.3% (7 out of 30)

Control group: 20% (6 out of 30)

El-Ebiary et al. − 2017

Egypt

30 (15 in intervention and 15 in control)

Patients (male or female, aged 18 years or older) with symptomatic acute ALP poisoning (deliberate or accidental), were included

Patients received NAC 140 mg/Kg IV infusion (as a loading dose), then 70 mg/Kg IV infusion every 4 h up to 17 doses, In addition, the routine treatment was given, and it

consists of patient resuscitation, gastric decontamination

From 18–28 years old : (86.7%) (80.0%)

From 28–38 years old : (13.3%) (6.7%)

From 38–48 years old:

(0.0%) (13.3%)

M/F23.3%/26.6%

M/F20%/30%

Hypotension

(73.3%)(93.3%)

Hypertension (6.7%)(0.0%)

Normal (20.0%)(6.7%)

Undetected (0.0%) (13.3%)

Bradycardia (0.0%) (6.7%)

Tachycardia (33.3%) (46.7%)

Normal (66.7%) (33.3%)

On admission 17.48 ± 7.48

16.23 ± 7.91

After treatment

2.79 ± 1.82

17.26 ± 6.39 -

On admission

1.99 ± 0.77

3.23 ± 2.16

After treatment

0.66 ± 0.26

2.15 ± 1.44

NA

NA

Intervention group: 33.3% (5 out of 15)

Control group: 80% (12 out of 15)

Intervention group: 46.7% (7 out of 15)

Control group: 80% (12 out of 15)

48 (13–48)

12 (8–13)