Cyanide intoxication as part of smoke inhalation - a review on diagnosis and treatment from the emergency perspective

Lawson-Smith, Pia; Jansen, Erik C.; Hyldegaard, Ole

doi:10.1186/1757-7241-19-14

Cited by 86 publications

(68 citation statements)

References 46 publications

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“…Many patients are at increased risk of multiple potential causes such as thiamine deficiency or liver dysfunction in septic shock 18 , seizures in the setting of alcohol intoxication or drug abuse 147,148 or cyanide/carbon monoxide poisoning in the setting of burns with concurrent smoke inhalation 149 .…”

Section: Approach To the Patient With Elevated Lactatementioning

confidence: 99%

Etiology and Therapeutic Approach to Elevated Lactate Levels

Andersen

Mackenhauer

Roberts

et al. 2013

Mayo Clinic Proceedings

572

444

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Lactate levels are commonly evaluated in acutely ill patients. Although most commonly used in the context of evaluating shock, lactate can be elevated for many reasons. While tissue hypoperfusion is probably the most common cause of elevation, many other etiologies or contributing factors exist. Clinicians need to be aware of the many potential causes of lactate elevation as the clinical and prognostic importance of an elevated lactate varies widely by disease state. Moreover, specific therapy may need to be tailored to the underlying cause of elevation. The current review is based on a comprehensive PubMed search and contains an overview of the pathophysiology of lactate elevation followed by an in-depth look at the varied etiologies, including medication-related causes. The strengths and weaknesses of lactate as a diagnostic/prognostic tool and its potential use as a clinical endpoint of resuscitation will be discussed. The review ends with some general recommendations on management of patients with elevated lactate.

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Section: Approach To the Patient With Elevated Lactatementioning

confidence: 99%

Etiology and Therapeutic Approach to Elevated Lactate Levels

Andersen

Mackenhauer

Roberts

et al. 2013

Mayo Clinic Proceedings

572

444

View full text Add to dashboard Cite

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“…However, mild CO poisoning is recognized as a cause of permanent neurological injury, ranging from extrapyramidal manifestations of varying intensity to a persistent vegetative state progressing over the years. ( 40 ) …”

Section: Hcn Poisoningmentioning

confidence: 99%

“…The physiological rationale is based on a greater induction of nitric oxide formation in the bloodstream, nitric oxide competing with HCN for the binding to the enzyme cytochrome c oxidase a. ( 40 ) A quasi-experimental study showed no reduction in blood concentrations of HCN after HBOT in SII victims. ( 43 ) …”

Section: Hcn Poisoningmentioning

confidence: 99%

Smoke inhalation injury during enclosed-space fires: an update

2013

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In view of the tragic fire at a nightclub in the city of Santa Maria, Brazil, which culminated in the sudden death of 232 young people, we decided to review the literature regarding smoke inhalation injury caused by enclosed-space fires, which can be divided into direct thermal damage, carbon monoxide poisoning, and cyanide poisoning. Such injuries often call for immediate orotracheal intubation, either due to acute airway obstruction or due to a reduced level of consciousness. The diagnosis and the severity of the thermal injury can be determined by fiberoptic bronchoscopy. The levels of gases and gas by-products in the bloodstream should be assessed as rapidly as possible, even while still at the scene of the incident. First responders can also treat carbon monoxide poisoning, with immediate administration of oxygen at 100%, as well as cyanide poisoning, with oxygen therapy and hydroxocobalamin injection

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“…Carbon monoxide (CO) and hydrogen cyanide (HCN) are two of the main noxious gases [1,2], whereby HCN is formed by an incomplete combustion of materials containing nitrogen [3]. These materials may be natural materials, such as wool, silk and feathers or synthetic plastics, such as polyacrylonitrile (PAN), polyamide and polyurethane.…”

Section: Introductionmentioning

confidence: 99%