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Intramuscular aminotetrazole cobinamide as a treatment for inhaled hydrogen sulfide poisoning in a large swine model
Annals of the New York Academy of Sciences ( IF 4.728 ) Pub Date : 2020-03-31 , DOI: 10.1111/nyas.14339
Tara B. Hendry‐Hofer; Patrick C. Ng; Alison M. McGrath; David Mukai; Matthew Brenner; Sari Mahon; Joseph K. Maddry; Gerry R. Boss; Vikhyat S. Bebarta

Hydrogen sulfide (H2S), a high‐threat chemical agent, occurs naturally in a variety of settings. Despite multiple incidents of exposures and deaths, no FDA‐approved antidote exists. A rapid‐acting, easy to administer antidote is needed. We conducted a randomized control trial in swine comparing intramuscular administration of aminotetrazole cobinamide (2.9 mL, 18 mg/kg) to no treatment following inhalation of H2S gas. We found that aminotetrazole cobinamide administered 2 min after the onset of respiratory depression—defined as a tidal volume of less than 3 mL/kg for 2 consecutive minutes—yielded 100% survival, while all control animals died. Respiratory depression resolved in the treatment group within 3.6 ± 1.5 min (mean ± SD) of cobinamide administration, whereas control animals had intermittent gasping until death. Blood pressure and arterial oxygen saturation (SO2) returned to baseline values within 5 and 10 min, respectively, of cobinamide treatment, and plasma lactate concentration decreased to less than 50% of the highest value by the end of the experiment. In control animals, plasma lactate rose continuously until death. We conclude that intramuscular aminotetrazole cobinamide is effective in a large animal, inhalational model of acute, severe H2S poisoning.
更新日期:2020-04-21

 

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