Hydroxycobalamin, hyperbaric oxygen and cyanide poisoning.

摘要

From initial analysis of the literature [1-5] and the first HBO Committee Reports [6], cyanide intoxication (CNHI) appeared in the list of potential indications for hyperbaric oxygen (HBO2) therapy. Some references were found years later [7-11]. The therapeutic mechanism was not obvious, and many physicians did not consider HBO2 in the treatment of CNHI as a reliable or consistent indication. Further, there was a general assumption that this very serious intoxication is rarely seen in emergency units of general hospitals, mainly because this poisoning is usually very serious, even fatal, in the majority of cases, thus with very few chances for survival. Additionally, there was no clinical or analytical base for a clear diagnosis of CNHI because no easy, rapid, and inexpensive analytical test is available even today that permits detection of the existence of CNH in the blood of victims in which a suspicion of CNHI exists.