Chenuel B, Sonobe T, Haouzi P
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Pennsylvania State University College of Medicine , Hershey, PA , USA.
Clin Toxicol (Phila). 2015 Feb;53(2):93-101. doi: 10.3109/15563650.2014.996570. Epub 2015 Jan 29.
We have recently reported that infusion of a solution containing methemoglobin (MetHb) during exposure to hydrogen sulfide results in a rapid and large decrease in the concentration of the pool of soluble/diffusible H2S in the blood. However, since the pool of dissolved H2S disappears very quickly after H2S exposure, it is unclear if the ability of MetHb to "trap" sulfide in the blood has any clinical interest and relevance in the treatment of sulfide poisoning.
In anesthetized rats, repetition of short bouts of high level of H2S infusions was applied to allow the rapid development of an oxygen deficit. A solution containing MetHb (600 mg/kg) or its vehicle was administered 1 min and a half after the end of H2S intoxication.
The injection of MetHb solution increased methemoglobinemia to about 6%, almost instantly, but was unable to affect the blood concentration of soluble H2S, which had already vanished at the time of infusion, or to increase combined H2S. In addition, H2S-induced O2 deficit and lactate production as well as the recovery of carotid blood flow and blood pressure were similar in treated and control animals.
Our results do not support the view that administration of MetHb or drugs-induced methemoglobinemia during the recovery phase following severe H2S intoxication in sedated rats can restore cellular oxidative metabolism, as the pool of diffusible sulfide, accessible to MetHb, disappears rapidly from the blood after H2S exposure.
我们最近报道,在暴露于硫化氢期间输注含有高铁血红蛋白(MetHb)的溶液会导致血液中可溶性/可扩散硫化氢(H2S)池的浓度迅速大幅下降。然而,由于H2S暴露后溶解的H2S池很快消失,尚不清楚MetHb在血液中“捕获”硫化物的能力在硫化物中毒治疗中是否具有临床意义和相关性。
在麻醉大鼠中,重复短时间的高水平H2S输注以促使快速出现氧亏缺。在H2S中毒结束后1分半钟给予含有MetHb(600mg/kg)的溶液或其赋形剂。
注射MetHb溶液几乎立即使高铁血红蛋白血症增加至约6%,但无法影响可溶性H2S的血液浓度,输注时该浓度已消失,也无法增加结合态H2S。此外,治疗组和对照组动物中H2S诱导的氧亏缺和乳酸生成以及颈动脉血流和血压的恢复情况相似。
我们的结果不支持以下观点,即在镇静大鼠严重H2S中毒后的恢复阶段给予MetHb或药物诱导的高铁血红蛋白血症可恢复细胞氧化代谢,因为MetHb可接触到的可扩散硫化物池在H2S暴露后会迅速从血液中消失。