Elevated plasma cyanide level after hydroxocobalamin infusion for cyanide poisoning

Hydroxocobalamin for Poisoning Caused by Ingestion of Potassium Cyanide: A Case Study

“…This case supplements other reports of use of hydroxocobalamin for acute cyanide poisoning from ingestion or exposure to cyanide gas (11)(12)(13)(14). In a recently reported case, hydroxocobalamin 5 g with supportive care was administered to a comatose 51-year-old man beginning 2.5 h after he attempted suicide by drinking a potassium cyanide solution (13). The patient could obey verbal orders within minutes of hydroxocobalamin infusion, and was discharged from the hospital with no neurological deficits on the 5 th day after cyanide ingestion.…”

“…Hydroxocobalamin administration beginning between 15 and 30 min after cyanide ingestion to a total dose of 10 g was associated with rapid stabilization of hemodynamic parameters and recovery of consciousness, and the patient was discharged from Intensive Care 6 days after the poisoning with no neurological or other sequelae. This case supplements other reports of use of hydroxocobalamin for acute cyanide poisoning from ingestion or exposure to cyanide gas (11)(12)(13)(14). In a recently reported case, hydroxocobalamin 5 g with supportive care was administered to a comatose 51-year-old man beginning 2.5 h after he attempted suicide by drinking a potassium cyanide solution (13).…”

“…For empiric prehospital antidotal treatment to be practicable, the risk of introducing harm by administering the antidote should be low regardless of whether the presumptive diagnosis of cyanide poisoning is correct. Hydroxocobalamin administered in the prehospital setting for presumptive cyanide poisoning was not associated with adverse events in the current case or in other studies (8,9,(11)(12)(13)(14).…”

Pediatric Cyanide Poisoning: Causes, Manifestations, Management, and Unmet Needs

“…86 Licensed as a cyanide antidote in France in 1996, hydroxocobalamin has been used to treat known or suspected cyanide poisoning associated with smoke inhalation, industrial exposure to cyanide gas, and ingestion of cyanide salts. 44,75,[87][88][89][90][91][92][93][94][95][96] Hydroxocobalamin has also been used in other countries including Sweden, Denmark, Spain, Japan, and Hong Kong. [97][98][99][100][101] It has been administered to pediatric patients as well as adults.…”

Antidotes and Treatments for Chemical Warfare/Terrorism Agents: An Evidence-Based Review

“…The data include those from two uncontrolled studies, both in patients with smoke inhalation and presumed cyanide exposure and in some case reports and small series. 44 , 45 , 46 , 47 , 48 , 49 …”