Global & Disaster Medicine

IM Sodium Nitrite and Sodium Thiosulfate Are Effective Against Acute Cyanide Poisoning

Sodium Nitrite and Sodium Thiosulfate Are Effective Against Acute Cyanide Poisoning When Administered by Intramuscular Injection

Vikhyat S. Bebarta, Matthew Brittain, Adriano Chan, Norma Garrett, David Yoon, Tanya Burney, David Mukai, Michael Babin, Renate B. Pilz, Sari B. Mahon, Matthew Brenner, Gerry R. Boss
DOI: http://dx.doi.org/10.1016/j.annemergmed.2016.09.034
p718–725.e4
“…..Results

We found that sodium nitrite and sodium thiosulfate individually rescued 100% of the mice, and that the combination of the 2 drugs rescued 73% of the rabbits and 80% of the pigs. In all 3 species, survival in treated animals was significantly better than in control animals (log rank test, P<.05). In the pigs, the drugs attenuated an increase in the plasma lactate concentration within 5 minutes postantidote injection (difference: plasma lactate, saline solution–treated versus nitrite- or thiosulfate-treated 1.76 [95% confidence interval 1.25 to 2.27]).

Conclusion

We conclude that sodium nitrite and sodium thiosulfate administered by intramuscular injection are effective against severe cyanide poisoning in 3 clinically relevant animal models of out-of-hospital emergency care…..”


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