Department of Emergency and Critical Care Medicine, School of Medicine, Kitasato University , 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan.
Clin Toxicol (Phila). 2013 Jun;51(5):425-8. doi: 10.3109/15563650.2013.799676.
In Japan, suicide by inhaling hydrogen sulfide (H2S) by mixing commercial products escalated into a nationwide trend in April 2008.
We conducted a multicenter retrospective survey on the demographics, clinical features, treatments, and outcomes of patients exposed to H2S suicide attempts.
Subjects included patients transported to emergency facilities in Japan from January 2005 to December 2011 following H2S suicide attempts. Among 277 facilities to which a letter requesting data collection was sent, questionnaires were sent to and filled out by the 47 (18%) facilities that agreed to provide data. Questionnaires were collected and data were extracted at Kitasato University.
A total of 156 patients were included in this survey. Patients involved in an H2S suicide attempt increased from 1 in 2007 to 51 in 2008, and gradually decreased from 44 in 2009 to 37 in 2010 and 23 in 2011. Ninety-two patients attempted H2S suicide (primary exposure group), and 64 were secondarily affected by the suicide attempt (secondary exposure group). Patients in the primary exposure group were young (mean, 30.3 years (10.9)), and male patients (n = 62) were approximately two times more likely to attempt H2S suicide than females (n = 30). Forty-eight patients in cardiopulmonary arrest at the scene did not survive. Five non-cardiopulmonary arrest patients died, and five patients who presented with a Glasgow coma scale (GCS) < 8 and lactic acidosis had neurological or cardiac signs or symptoms at discharge. Antidote therapy was performed on 26 of the primary group patients, but with poor outcomes. None of the secondary group patients were in cardiopulmonary arrest at the scene, five received antidotal therapy after arriving at the hospital, and all completely recovered from H2S exposure.
Mortality (58%) among patients who attempted H2S suicide was very high, likely resulting from inhaling high concentrations of H2S after mixing commercial products in a sealed and confined space.
2008 年 4 月，日本因将商用产品混合吸入硫化氢（H2S）自杀的案例急剧增加，成为全国性趋势。
我们对接触 H2S 自杀未遂的患者的人口统计学、临床特征、治疗和结局进行了多中心回顾性调查。
研究对象包括 2005 年 1 月至 2011 年 12 月期间因 H2S 自杀未遂被送往日本急救设施的患者。在向 277 家医疗机构发出收集数据的信函中，有 47 家（18%）同意提供数据的机构寄发了调查问卷，并填写了问卷。调查问卷在北里大学进行了收集和数据提取。
共有 156 名患者纳入本调查。参与 H2S 自杀未遂的患者从 2007 年的 1 人增加到 2008 年的 51 人，随后从 2009 年的 44 人逐渐减少到 2010 年的 37 人和 2011 年的 23 人。92 名患者尝试了 H2S 自杀（原发性暴露组），64 名患者为继发性暴露。原发性暴露组患者较年轻（平均年龄 30.3 岁（10.9）），男性患者（n = 62）尝试 H2S 自杀的可能性是女性患者（n = 30）的两倍。现场心肺骤停的 48 名患者未存活。5 名非心肺骤停患者死亡，5 名格拉斯哥昏迷量表（GCS）<8 且乳酸酸中毒的患者在出院时出现神经或心脏体征或症状。对 26 名原发性组患者进行了解毒治疗，但效果不佳。现场无继发性组患者出现心肺骤停，5 名患者在到达医院后接受解毒治疗，所有患者均完全从 H2S 暴露中恢复。
尝试 H2S 自杀的患者死亡率（58%）非常高，这可能是由于在密封且封闭的空间中将商用产品混合后吸入了高浓度的 H2S。
