CYANIDE POISONING

  • Hall AH, Rumack BH: Clinical toxicology of cyanide. Ann Emerg Med 1986;15:1067-1074.
    A comprehensive review of the subject, written by Rocky Mountain Poison and     Drug Center physicians (highly respected national experts on poisoning and overdoses). With regard to its treatment the authors advocate HBO therapy, particularly when supportive measures, and other cyanide antidotes fail.
  • Gonzales J, Sabatini S: Cyanide poisoning: pathophysiology and current approaches to therapy. The Internat J Artificial Organs 1989;12(6):347-355.
    A second review, in which the authors again recommend the use of HBO therapy in selected cases. Given the date of this paper (1969) the authors rule out its use in infants and children due to potential risk factors, (risks not borne out in modern hyperbaric practice).
  • Cope C: The importance of oxygen in the treatment of cyanide poisoning. JAMA 1961;175(12):109-112.
    In a cyanide poisoned animal model, the protective effect of oxygen on cardiac tissue is demonstrated. The author emphasizes the "paramount importance of including oxygen in the immediate treatment. It is noteworthy that oxygen administration is advocated even though hypoxia/anoxia is histotoxic. It is further reported that "oxygen is not only important, but indeed a specific antidote in cyanide poisoning".
  • Way JL, Gibbon SL, Sheehy M: Effect of oxygen on cyanide intoxication. I. Prophylactic protection. The J Pharm and Experimental Therapeutics 1966;153(2):381-385.
    Another animal model of cyanide poisoning, in which the authors conclude "when it is employed in combination with other cyanide antagonist(s), oxygen potentiates the effectiveness of sodium nitrite and sodium thiosulfate".
  • Takano T, Miyazaki Y, Nashimoto I, et al: Effect of hyperbaric oxygen on cyanide intoxication: in situ changes in intracellular oxidation reduction. Undersea Biomed Res 1980;7(3):191-197.
    This study was specifically designed to study the effect of HBO therapy in a model of cyanide poisoning. "It appears that oxygen has an antidotal potency when the dose of cyanide is at the critical, or just over the critical, level for mitochondrial respiratory function". "We consider that clinical administration of hyperbaric oxygen at a mild pressure represents a significant treatment if proper chemical treatment is carried out concomitantly".
  • Davis FM, Ewer T: Acute cyanide poisoning: case report of the use of hyperbaric oxygen. J Hyper Med 1988;3(2):103-106.
    A case report, in which initial measures appeared to fail, but that "full consciousness was regained rapidly during the first 20 minutes (of) HBO". The patient made an uneventful recovery.
  • Sheehy M, Way JL: Effect of oxygen on cyanide intoxication. III. Mithridate. J Pharmacol Exp Therap 1968;161(1):163-168.
    An in-vivo study, evaluating the effects of oxygen on cyanide intoxication. The authors note that oxygen "strikingly potentiates the antidotal effect of sodium thiosulfate …"