In this study, we developed a rapid
and easy method to determine
cyanide (CN) intoxication by quantification of CN and 2-aminothiazoline-4-carboxylic
acid (ATCA), which is a new and reliable indicator of CN exposure,
in the human blood using probe electrospray ionization tandem mass
spectrometry (PESI/MS/MS) named RECiQ. For CN, we applied the previously
reported one-pot derivatization method using 2,3-naphthalenedialdehyde
and taurine, which can directly derivatize CN in the blood. The analytical
conditions of the CN derivatization were optimized as a 10 min reaction
time at room temperature. In contrast, ATCA could be directly detected
in the blood by PESI/MS/MS. We developed quantitative methods for
the derivatized CN and ATCA using an internal standard method and
validated them using quality control samples, demonstrating that the
linearities of each calibration curve were greater than 0.995, and
intra- and interday precisions and accuracies were 5.1–15 and
1.1–14%, respectively. Moreover, the lower limit of detections
for CN and ATCA were 42 and 43 ng/mL, respectively. Finally, we applied
RECiQ to three postmortem blood specimens obtained from victims of
fire incidents, which resulted in the successful quantification of
CN and ATCA in all samples. As PESI/MS/MS can be completed within
0.5 min, and the sample volume requirement of RECiQ is only 2 μL
of blood, these methods are useful not only for the rapid determination
of CN exposure but also for the estimation of the CN intoxication
levels during an autopsy.