title: [Cyanide poisoning. Priority to symptomatic treatment. 25 cases].
abstract: A retrospective study of 25 cases of cyanide poisoning has brought to light the following points: cardiorespiratory arrests are frequent (7/25) and often inaugural; in severe intoxications (7/25), deep metabolic acidosis is the rule, and cyanide poisoning should always be suspected in cases of coma with severe acidosis; mild intoxications are frequently symptomless. Anxiety and agitation should not be considered as evidence of cyanide poisoning; they are merely due to fear in most cases. The present treatment of acute cyanide poisoning relies basically on symptomatic measures: sodium bicarbonate, cardiac massage and, above all, assisted ventilation with 100% oxygen. Our experience does not support the concept of a lethal cyanide blood level when patients can rapidly be transferred by a medical team to an intensive care unit. Survival depends more on prompt medical care than on the accessibility to sophisticated antidotes.
mesh_terms: D000138:Acidosis / Q000139:chemically induced; D003486:Cyanides / Q000097:blood / Q000506:poisoning*; D006801:Humans; D007773:Lactates / Q000378:metabolism; D010102:Oxygen Inhalation Therapy; D012189:Retrospective Studies
chemical_list: D003486:Cyanides; D007773:Lactates
vernacular_title: Intoxication cyanhydrique. Primauté du traitement symptomatique. Vingt-cinq observations.