Barillo D J, Goode R, Esch V
Newark Fire Department, New Jersey.
J Burn Care Rehabil. 1994 Jan-Feb;15(1):46-57. doi: 10.1097/00004630-199401000-00010.
Cyanide is produced by the combustion of natural and synthetic materials. It is assumed that cyanide poisoning is a major component of smoke inhalation injury; however, scientific verification of this assumption is lacking. In this study we examined blood carboxyhemoglobin and cyanide levels in fire fatalities. Carboxyhemoglobin levels of 433 fatalities averaged 44.9% and exceeded fatal (> or = 50%) levels in 195 cases. Cyanide levels of 364 fatalities averaged 1.0 mg/L and exceeded fatal levels (> 3 mg/L) in 31 cases. For victims with cyanide levels above 3 mg/L the mean carboxyhemoglobin level was 62.5%. Cyanide poisoning is infrequent in fire fatalities, and when present it is associated with significant carboxyhemoglobinemia. Cyanide can be both produced and degraded in blood and tissue, making interpretation of blood levels difficult. In survivors of fire, detoxification of cyanide can occur without specific antidotes with the use of aggressive supportive care. Specific assay and treatment for cyanide poisoning is rarely necessary in the treatment of victims of smoke and fire.
氰化物由天然和合成材料燃烧产生。据推测，氰化物中毒是烟雾吸入性损伤的主要组成部分；然而，这一推测缺乏科学验证。在本研究中，我们检测了火灾遇难者血液中的碳氧血红蛋白和氰化物水平。433名遇难者的碳氧血红蛋白水平平均为44.9%，其中195例超过致死水平（≥50%）。364名遇难者的氰化物水平平均为1.0mg/L，其中31例超过致死水平（>3mg/L）。对于氰化物水平高于3mg/L的受害者，平均碳氧血红蛋白水平为62.5%。氰化物中毒在火灾遇难者中并不常见，一旦出现则与严重的碳氧血红蛋白血症相关。氰化物可在血液和组织中生成和降解，使得对血液水平的解读变得困难。在火灾幸存者中，通过积极的支持性治疗，即使不使用特定解毒剂，氰化物也可被解毒。在烟雾和火灾受害者的治疗中，很少需要对氰化物中毒进行特定检测和治疗。
