Sodium Thiosulfate Versus Hydroxocobalamin in the Treatment of Acute, Severe Cyanide Induced Cardiotoxicity in a Swine (Sus Scrofa) Model

摘要

To compare the return to baseline of mean arterial blood pressure (MAP) between 3 groups of swine with acute CN toxicity and treated with HOCOB, ST, or a combination of HOCOB+ST. 36 swine ( 48-52kg) were intubated, anesthetized, instrumented and then poisoned with a continuous CN infusion, until the development of severe hypotension (Time 0-50% of baseline MAP). Animals were randomly assigned to the groups and monitored for 60 min after the start of the antidotal infusion. Baseline mean weights, time to hypotension, and CN dose at hypotension were similar. Mean CN blood levels and lactate levels at Time 0 were also similar.- All of the 12 animals in the ST group died before the conclusion of the study as compared to 2 in the HOCOB/ST group and 1 in the HOCOB group. Conclusion: Sodium Thiosulfate failed to reverse cyanide- induced shock in our swine model of severe cyanide toxicity. ST also failed to augment the efficacy of HOCOB on cyanide-induced shock in our model of severe cyanide toxicity. HOCOB was again found to be effective in treating severe cyanide toxicity.