Cyanide poisoning in patients with inhalation injury – the phantom menace

Raška, F; Lipový, Břetislav; Hladik, Michaela; Holoubek, Jakub

doi:10.48095/ccachp2021185

Cited by 3 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7 Nitrites, such as sodium nitrite or amyl nitrite, induce the oxidation of iron in hemoglobin, changing it from ferrous to ferric iron and resulting in the formation of methemoglobin which can then bind cyanide. 8,16 The efficacy of amyl nitrite inhalation as an initial remedy for cyanide poisoning is a subject of frequent debate due to its limited capacity to generate methemoglobin beyond 6%. Additionally, nitrite induces vasodilation and presents adverse side effects such as hypotension and syncope, restricting its use.…”

Section: Discussionmentioning

confidence: 99%

“…Hydroxocobalamin, a naturally occurring variant of vitamin B12, serves as one such antidote. It replaces the hydroxy group with cyanide, leading to the formation of cyanocobalamin, a nontoxic substance eliminable through the kidneys 16 . Hydroxocobalamin has not been associated with clinically significant adverse effects, except for isolated allergic reactions, headaches, temporary asymptomatic increases in blood pressure and bradycardia, as well as skin and urine discoloration.…”

Section: Discussionmentioning

confidence: 99%

“…The efficacy of amyl nitrite inhalation as an initial remedy for cyanide poisoning is a subject of frequent debate due to its limited capacity to generate methemoglobin beyond 6%. Additionally, nitrite induces vasodilation and presents adverse side effects such as hypotension and syncope, restricting its use 16 . In the absence of hydroxocobalamin, it is advised to administer sodium nitrite for cyanide poisoning 18 .…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have evaluated the effectiveness of sodium thiosulfate when administered in conjunction with other antidotes, such as hydroxocobalamin. It is important to note that thiosulfate is contraindicated for patients with renal insufficiency due to the potential toxicity resulting from the formation of thiocyanate 16 . The Lily Cyanide Antidote Kit, containing amyl nitrite, sodium nitrite, and sodium thiosulfate, is no longer available 7 .…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Cyanide poisoning after bitter almond ingestion: “A rare case report”

Arabizadeh,

Mahmoudi,

Gandomani

et al. 2024

Clinical Case Reports

View full text Add to dashboard Cite

Key Clinical MessageWe present a case of a 36‐year‐old woman with a history of three suicide attempts who had ingested approximately 40 bitter almonds in a suicidal act, leading to her admission to the emergency department of a regional hospital due to complaints of vomiting. Upon arrival, she exhibited confusion, and her vital signs were recorded as follows: pulse rate = 117 beats/min, blood pressure = 160/85 mmHg, oxygen saturation = 95%, respiratory rate = 16, temperature = 37°C. The patient venous blood gas analysis manifested severe metabolic acidosis (pH = 6.92, pO2 = 43 mmHg, HCO3 = 8.6 mmol/L, pCO2 = 42.7 mmHg, base excess = −25.9 mmol/L). Four hours later, she became unconscious and she was intubated. Gastric lavage and a single dose of 60 g of activated charcoal and sodium bicarbonate were administered. In the referral hospital, sodium nitrite was given due to the severity of the poisoning, and norepinephrine infusion was initiated to manage hypotension. Within a day, the patient regained consciousness, underwent extubation, and after 72 h was discharged and subsequently transferred to psychiatric care for further treatment. This case underscores the critical, life‐threatening implications of cyanide toxicity following the ingestion of bitter almonds, highlighting the efficacy of supportive measures such as gastric lavage, activated charcoal, and sodium bicarbonate. Furthermore, it emphasizes the successful application of sodium nitrite monotherapy in managing this condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Cyanide poisoning after bitter almond ingestion: “A rare case report”

Arabizadeh,

Mahmoudi,

Gandomani

et al. 2024

Clinical Case Reports

View full text Add to dashboard Cite

show abstract

“…[ 4 ] The accuracy of the clinical evaluation for determining whether an indeterminate or deep partial-thickness burn will progress into a full-thickness burn has been shown to be as low as 50–76%. [ 5 – 7 ] This low-accuracy rate often results in delaying clinical diagnosis until the burn “declares its nature.” In other words, the diagnosis must wait until the burn reaches its maximum depth, which usually occurs after a few days post-burn. On the other hand, early excision and grafting of full thickness burns results in overall better patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

In Vivo Assessment and Monitoring of Burn Wounds Using a Handheld Terahertz Hyperspectral Scanner

Osman

Harris

Zhou

et al. 2022

Advanced Photonics Research

View full text Add to dashboard Cite

The accuracy of clinical assessment techniques in diagnosing partial‐thickness burn injuries has remained as low as 50–76%. Depending on the burn depth and environmental factors in the wound, such as reactive oxygen species, inflammation, and autophagy, partial‐thickness burns can heal spontaneously or require surgical intervention. Herein, it is demonstrated that terahertz time‐domain spectral imaging (THz‐TDSI) is a promising tool for in vivo quantitative assessment and monitoring of partial‐thickness burn injuries in large animals. We used a novel handheld THz‐TDSI scanner to characterize burn injuries in a porcine scald model with histopathological controls. Statistical analysis (n = 40) indicates that the THz‐TDSI modality can accurately differentiate between partial‐thickness and full‐thickness burn injuries (1‐way ANOVA, p < 0.05). THz‐TDSI has the potential to improve burn care outcomes by helping surgeons in making objective decisions for early excision of the wound.

show abstract

Nature’s Toxic Gift

2023

Poisonous Tales

View full text Add to dashboard Cite

In an intriguing and clever murder in The Liqueur Glass by Phyllis Bottome (1915), a wife poisons her husband with a chemical from a photography dark-room, adding it to his glass of sloe gin. The poison isn’t named, but of all the compounds used in developing black & white prints, cyanide is the most likely culprit. Mr Watkins dies within minutes because cyanide attacks his red blood cells, blocking a key enzyme from doing its life-giving job. Even though he is breathing, his cells can no longer use the oxygen and begin to die. His death is investigated, and various non-toxicological clues suggest to the doctor that poison was the culprit. We will look at the trail of hints cyanide leaves on its victims, and explore the natural and synthetic sources of the poison. Although cyanide will be forever associated with spies taking their secrets to the grave, we will examine the most common cause of cyanide poisoning forensic toxicologists encounter – toxic fumes in fires.

show abstract

Cyanide poisoning in patients with inhalation injury – the phantom menace

Cited by 3 publications

References 0 publications

Cyanide poisoning after bitter almond ingestion: “A rare case report”

Cyanide poisoning after bitter almond ingestion: “A rare case report”

In Vivo Assessment and Monitoring of Burn Wounds Using a Handheld Terahertz Hyperspectral Scanner

Nature’s Toxic Gift

Contact Info

Product

Resources

About