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[Potassium cyanide poisoning treated with hydroxocobalamin]
1Département d'Anesthésie-Réanimation, Hôpital Saint-Jacques, Clermont-Ferrand.
Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1990
Summary
A teenage girl survived severe cyanide poisoning after rapid treatment with hydroxocobalamin and sodium hyposulfite. Prompt medical intervention, including antidotes and supportive care, reversed critical symptoms and led to recovery.
Area of Science:
- Toxicology
- Emergency Medicine
- Pharmacology
Background:
- Cyanide poisoning is a life-threatening condition requiring immediate medical attention.
- Severe poisoning presents with coma, circulatory failure, and metabolic acidosis.
- Rapid administration of specific antidotes is crucial for survival.
Observation:
- A 15-year-old female presented with severe symptoms of cyanide poisoning 90 minutes after ingesting 2.5 g of potassium cyanide.
- She exhibited deep coma, circulatory failure, and severe metabolic acidosis.
- Blood cyanide concentration on admission was critically high at 494 mumol.l-1.
Findings:
- The patient received prompt gastric lavage, hydroxocobalamin (4 g), and sodium hyposulfite (8 g) as antidotal therapy.
- Supportive care included mechanical ventilation, blood alkalinization, and beta-stimulants.
- Rapid clinical improvement was observed following treatment initiation.
Implications:
- This case highlights the efficacy of early symptomatic and antidotal treatment in managing severe cyanide poisoning.
- Hydroxocobalamin and sodium hyposulfite, combined with supportive care, can be life-saving even in cases of extreme cyanide exposure.
- Prompt medical intervention is critical for favorable outcomes in acute cyanide toxicity.