title: The metabolic effects of fatal cyanide poisoning.
abstract: Metabolic and toxicological data were obtained during the first 24 hours following severe and eventually fatal cyanide poisoning. Initial blood cyanide concentrations were 804 mumol/l but fell rapidly over 24 hours following cobalt edetate therapy to 15 mumol/l. However, plasma thiocyanate concentrations rose over 24 hours (147-267 mumol/l) suggesting continued tissue detoxification. The major metabolic abnormality was lactic acidosis (initial pH 7.21, blood lactate 17.5 mmol/l) which corrected over 12 hours. Despite high circulating insulin concentrations the responses of blood glucose, plasma non-esterified fatty acid, blood glycerol and 3-hydroxybutyrate suggested marked insulin resistance.
authors.affiliation: General Hospital, Birmingham, UK.
authors.forename: B M
authors.initials: BM
authors.lastname: Singh
authors.forename: N
authors.initials: N
authors.lastname: Coles
authors.forename: P
authors.initials: P
authors.lastname: Lewis
authors.forename: R A
authors.initials: RA
authors.lastname: Braithwaite
authors.forename: M
authors.initials: M
authors.lastname: Nattrass
authors.forename: M G
authors.initials: MG
authors.lastname: FitzGerald
mesh_terms: D000140:Acidosis, Lactic / Q000209:etiology / Q000378:metabolism*; D000328:Adult; D003486:Cyanides / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*; D006801:Humans; D008297:Male; D011041:Poisoning / Q000097:blood / Q000150:complications* / Q000378:metabolism; D014018:Tissue Distribution
chemical_list: D003486:Cyanides