Cyanide toxicity following nitroprusside induced hypotension
| Autor: | Eric W. Peterson, David West, David A. Aitken, John Cowan, Wojciech Poznanski, Frances J.D. Smith, Brien Benoit, J. B. Hurtig |
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| Rok vydání: | 1977 |
| Předmět: |
Adult
Male Nitroprusside Time Factors Adolescent Cellular respiration Cyanide Metabolite Hypotension Controlled chemistry.chemical_compound medicine Humans Ferricyanides Induced Hypotension Aged Cyanides business.industry Metabolic acidosis General Medicine Middle Aged medicine.disease Anesthesiology and Pain Medicine chemistry Anesthesia Intracranial surgery Toxicity Female Sodium nitroprusside Blood Gas Analysis Acidosis business Thiocyanates medicine.drug |
| Zdroj: | Canadian Anaesthetists’ Society Journal. 24:651-660 |
| ISSN: | 1496-8975 0008-2856 |
| Popis: | Several recently reported deaths following the use of sodium nitroprusside have been attributed to the accumulation of the nitroprusside metabolite, cyanide. In this study, brief nitroprusside infusions (mean = 36 minutes) were administered in currently recommended doses during intracranial surgery. The peak blood cyanide following the infusions was 65.2 +/- 17.5 microgram per cent (mean +/- SE) (n = 13). It occurred within 45 minutes after infusion. The highest cyanide level detected was 205 microgram per cent, which is within the range of reported lethal blood cyanide levels. Metabolic acidosis developed in the four patients with the highest blood cyanide levels (range 90-205 microgram per cent). This occurred between 45 and 180 minutes following the cyanide peak. Blood ATP levels were depressed in the same patients. These findings are indicative of disturbed aerobic metabolism. We conclude that there is evidence of cyanide toxicity when nitroprusside is infused into patients using currently recommended doses. We recommend that for short infusions the dose of sodium nitroprusside should not exceed 0.5 mg/kg. |
| Databáze: | OpenAIRE |
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