Details

Autor(en) / Beteiligte

• Hendry-Hofer, Tara B.
• Ng, Patrick C.
• McGrath, Alison M.
• Soules, Kirsten
• Mukai, David S.
• Chan, Adriano
• Maddry, Joseph K.
• White, Carl W.
• Lee, Jangwoen
• Mahon, Sari B.
• Brenner, Matthew
• Boss, Gerry R.
• Bebarta, Vikhyat S.

Titel

Intramuscular cobinamide as an antidote to methyl mercaptan poisoning

Ist Teil von

• Inhalation toxicology, 2021-01, Vol.33 (1), p.25-32

Ort / Verlag

England: Taylor & Francis

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Methyl mercaptan occurs naturally in the environment and is found in a variety of occupational settings, including the oil, paper, plastics, and pesticides industries. It is a toxic gas and deaths from methyl mercaptan exposure have occurred. The Department of Homeland Security considers it a high threat chemical agent that could be used by terrorists. Unfortunately, no specific treatment exists for methyl mercaptan poisoning. We conducted a randomized trial in 12 swine comparing no treatment to intramuscular injection of the vitamin B 12 analog cobinamide (2.0 mL, 12.5 mg/kg) following acute inhalation of methyl mercaptan gas. Physiological and laboratory parameters were similar in the control and cobinamide-treated groups at baseline and at the time of treatment. All six cobinamide-treated animals survived, whereas only one of six control animals lived (17% survival) (p = 0.0043). The cobinamide-treated animals returned to a normal breathing pattern by 3.8 ± 1.1 min after treatment (mean ± SD), while all but one animal in the control group had intermittent gasping, never regaining a normal breathing pattern. Blood pressure and arterial oxygen saturation returned to baseline values within 15 minutes of cobinamide-treatment. Plasma lactate concentration increased progressively until death (10.93 ± 6.02 mmol [mean ± SD]) in control animals, and decreased toward baseline (3.79 ± 2.93 mmol [mean ± SD]) by the end of the experiment in cobinamide-treated animals. We conclude that intramuscular administration of cobinamide improves survival and clinical outcomes in a large animal model of acute, high dose methyl mercaptan poisoning.