Changes in the parameters of oxygen metabolism in a clinical course recovering from potassium cyanide.
Poisoning with potassium cyanide is usually fatal because of the inhibition of cytochrome oxidase. The parameters of oxygen metabolism in a patient with cyanide poisoning who was admitted in a coma with seizures was monitored. The administration of amyl nitrite and sodium thiosulfate led to a rapid improvement: the parameters reflecting oxygen metabolism improved and the plasma level of cyanide decreased. The patient revived 1 1/2 hours after treatment. The arterial ketone body ratio (AKBR), which is the ratio of acetoacetate to beta-hydroxybutyrate in arterial blood and which reflects the redox state in liver mitochondria, improved dramatically following treatment. Because the AKBR changes in relation to electron transport in liver mitochondria, it seems to be a logical parameter for evaluating the effect of potassium cyanide poisoning on electron transport. The AKBR also reflects the efficacy of treatment for cyanide poisoning.
Nakatani
T
T
Trauma and Critical Care Center, Teikyo University School of Medicine, Tokyo, Japan.
Kosugi
Y
Y
Mori
A
A
Tajimi
K
K
Kobayashi
K
K
D020155:3-Hydroxybutyric Acid; D000090:Acetoacetates / Q000097:blood*; D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D004579:Electron Transport / Q000187:drug effects; D006801:Humans; D006885:Hydroxybutyrates / Q000097:blood*; D008297:Male; D008930:Mitochondria, Liver / Q000378:metabolism; D009566:Nitrates / Q000627:therapeutic use; D010100:Oxygen / Q000378:metabolism*; D000439:Pentanols / Q000627:therapeutic use; D011041:Poisoning / Q000188:drug therapy / Q000378:metabolism; D011190:Potassium Cyanide / Q000506:poisoning*; D013885:Thiosulfates / Q000627:therapeutic use
D000090:Acetoacetates; D000931:Antidotes; D006885:Hydroxybutyrates; D009566:Nitrates; D000439:Pentanols; D013885:Thiosulfates; C016635:acetoacetic acid; C017717:sodium thiosulfate; D011190:Potassium Cyanide; D010100:Oxygen; D020155:3-Hydroxybutyric Acid; C036285:amyl nitrate