Cyanide toxicity during cardiopulmonary bypass with small dose of nitroprusside: a case report

Autor: Kum-Hee Chung, Seo Min Park, In Chan Baek, Junheum Jang, Yong-Woo Hong, SoWoon Ahn
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Korean Journal of Anesthesiology, Vol 69, Iss 2, Pp 181-184 (2016)
Druh dokumentu: article
ISSN: 2005-6419
2005-7563
DOI: 10.4097/kjae.2016.69.2.181
Popis: Sodium nitroprusside (SNP) is an anti-hypertensive drug, commonly used to decrease the systemic vascular resistance and lower the blood pressure. When the amount of cyanide generated by the SNP exceeds the metabolic capacity for detoxification, cyanide toxicity occurs. Under general anesthesia and cardiopulmonary bypass (CPB), it may be difficult to detect the development of cyanide toxicity. In cardiac surgical patients, hemolysis, hypothermia and decreased organ perfusion, which emphasize the risk of cyanide toxicity, may develop as a consequence of CPB. In particular, hemolysis during CPB may cause an unexpected overproduction of cyanide due to free hemoglobin release. We experienced a patient who demonstrated SNP tachyphylaxis and cyanide toxicity during CPB, even though the total amount of SNP administered was much lower than the recommended dose. We therefore report this case with a review of the relevant literature.
Databáze: Directory of Open Access Journals