Baek Jong Geun, Jeong Hoar Lim, Park Ji Sook, Seo Ji Hyun, Park Eun Sil, Lim Jae Young, Park Chan Hoo, Woo Hyang Ok, Youn Hee Shang, Yeom Jung Sook
Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea.
Korean J Pediatr. 2010 Aug;53(8):805-8. doi: 10.3345/kjp.2010.53.8.805. Epub 2010 Aug 31.
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.
尽管硝普钠（SNP）常用于儿科重症监护病房，但在使用硝普钠治疗后可能会发生氰化物中毒。为治疗硝普钠引起的氰化物中毒，诊断后应立即给予解毒剂，如亚硝酸异戊酯、亚硝酸钠、硫代硫酸钠和羟钴胺素。在此，我们报告首例非常年幼的婴儿，其硝普钠诱导的氰化物中毒通过换血成功治愈。这种替代方法的成功可能与以下事实有关：换血不仅能从血液中清除氰化物，还能通过提供富含硫的血浆激活解毒系统。此外，换血用新鲜红细胞替代受氰化物污染的红细胞，从而比解毒剂治疗更快地提高血液的携氧能力。因此，我们认为换血可能是氰化物中毒重症病例的一种有效治疗方式。
