Bismuth C, Cantineau J P, Pontal P, Baud F, Garnier R, Poulos L
Presse Med. 1984 Nov 17;13(41):2493-7.
A retrospective study of 25 cases of cyanide poisoning has brought to light the following points: cardiorespiratory arrests are frequent (7/25) and often inaugural; in severe intoxications (7/25), deep metabolic acidosis is the rule, and cyanide poisoning should always be suspected in cases of coma with severe acidosis; mild intoxications are frequently symptomless. Anxiety and agitation should not be considered as evidence of cyanide poisoning; they are merely due to fear in most cases. The present treatment of acute cyanide poisoning relies basically on symptomatic measures: sodium bicarbonate, cardiac massage and, above all, assisted ventilation with 100% oxygen. Our experience does not support the concept of a lethal cyanide blood level when patients can rapidly be transferred by a medical team to an intensive care unit. Survival depends more on prompt medical care than on the accessibility to sophisticated antidotes.
一项对25例氰化物中毒病例的回顾性研究揭示了以下几点：心肺骤停很常见（25例中有7例），且常常是首发症状；在重度中毒病例（25例中有7例）中，深度代谢性酸中毒是规律表现，对于伴有严重酸中毒的昏迷病例应始终怀疑氰化物中毒；轻度中毒常常没有症状。焦虑和躁动不应被视为氰化物中毒的证据；在大多数情况下，它们仅仅是由于恐惧所致。目前急性氰化物中毒的治疗主要依靠对症措施：碳酸氢钠、心脏按压，尤其是100%氧气辅助通气。我们的经验不支持当患者能够迅速由医疗团队转至重症监护病房时存在致死性氰化物血药浓度这一概念。生存更多地取决于及时的医疗救治而非能否获得先进的解毒剂。
