[Therapeutic attitude in cyanide poisoning (author's transl)]

Abstract

According to experimental and clinical data, the present treatment of acute cyanide poisoning depends basically on: 1) Dicobaltetracemate in cases of occupational pathology to be given at the working area, to patients with giddiness or mental confusion, 2) Oxygen by assisted ventilation, associated to hydroxocobalamine and sodium thiosulfate, to be administered after admission (patients in coma or circulatory failure). Initial cardio-respiratory arrest requires immediate cardiac massage and assisted ventilation. The rapid cyanide metabolism makes useless the dialysis methods. Frequent complications as metabolic acidosis and acute pulmonary oedema respond to symptomatic treatment. If these therapeutic measures are rapidly applied in confirmed cyanide poisoning, the notion of lethal blood level should be reconsidered. Survivals have been observed with initial plasma levels of 6 mg/l.