title: Successful treatment by exchange transfusion of a young infant with sodium nitroprusside poisoning.
abstract: Although sodium nitroprusside (SNP) is often used in pediatric intensive care units, cyanide toxicity can occur after SNP treatment. To treat SNP-induced cyanide poisoning, antidotes such as amyl nitrite, sodium nitrite, sodium thiosulfate, and hydroxycobalamin should be administered immediately after diagnosis. Here, we report the first case of a very young infant whose SNP-induced cyanide poisoning was successfully treated by exchange transfusion. The success of this alternative method may be related to the fact that exchange transfusion not only removes the cyanide from the blood but also activates detoxification systems by supplying sulfur-rich plasma. Moreover, exchange transfusion replaces cyanide-contaminated erythrocytes with fresh erythrocytes, thereby improving the blood's oxygen carrying capacity more rapidly than antidote therapy. Therefore, we believe that exchange transfusion might be an effective therapeutic modality for critical cases of cyanide poisoning.
authors.affiliation: Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.
authors.forename: Jong Geun
authors.initials: JG
authors.lastname: Baek
authors.forename: Hoar Lim
authors.initials: HL
authors.lastname: Jeong
authors.forename: Ji Sook
authors.initials: JS
authors.lastname: Park
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Seo
authors.forename: Eun Sil
authors.initials: ES
authors.lastname: Park
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lim
authors.forename: Chan Hoo
authors.initials: CH
authors.lastname: Park
authors.forename: Hyang Ok
authors.initials: HO
authors.lastname: Woo
authors.forename: Hee Shang
authors.initials: HS
authors.lastname: Youn
authors.forename: Jung Sook
authors.initials: JS
authors.lastname: Yeom