ArticleAnnals of emergency medicine2017
Sodium Nitrite and Sodium Thiosulfate Are Effective Against Acute Cyanide Poisoning When Administered by Intramuscular Injection.
Article in Annals of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed, 74 citations in OpenAlex.
- Advances in the clinical applications of sodium thiosulphate.Annals of medicine · 2026Review
- Pharmacokinetics and Efficacy of a Cyanide-Neutralizing [MoJournal of biological inorganic chemistry : JBIC : a publication of the Society of Biological Inorganic Chemistry · 2026Article
- Intranasal Dimethyl Trisulfide: Long-Term Efficacy in an Acutely Lethal Large Swine Model of Cyanide Exposure.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2025Article
- Surveillance of Chemical Foodborne Disease Outbreaks in Zhejiang Province, China, 2011-2023.Foods (Basel, Switzerland) · 2025Article
- Role of hydrogen sulfide in health and disease.MedComm · 2024Review
- Sulfur-Element containing metabolic pathways in human health and crosstalk with the microbiome.Biochemistry and biophysics reports · 2023Review
- Pre-Treatment of Transplant Donors with Hydrogen Sulfide to Protect against Warm and Cold Ischemia-Reperfusion Injury in Kidney and Other Transplantable Solid Organs.International journal of molecular sciences · 2023Review
- Intramuscular administration of glyoxylate rescues swine from lethal cyanide poisoning and ameliorates the biochemical sequalae of cyanide intoxication.Toxicological sciences : an official journal of the Society of Toxicology · 2023Article
- The effect of sodium thiosulfate on immune cell metabolism during porcine hemorrhage and resuscitation.Frontiers in immunology · 2023Article
- Increasing use of sodium nitrite in suicides-an emerging trend.Forensic science, medicine, and pathology · 2022Article
- The Effects of HBiomedicines · 2022Article
- Article
- Real-Time High-Sensitivity Reaction Monitoring of Important Nitrogen-Cycle Synthons byJournal of the American Chemical Society · 2022Article
- Methyl mercaptan gas: mechanisms of toxicity and demonstration of the effectiveness of cobinamide as an antidote in mice and rabbits.Clinical toxicology (Philadelphia, Pa.) · 2022Article
- Development of sodium tetrathionate as a cyanide and methanethiol antidote.Clinical toxicology (Philadelphia, Pa.) · 2022Article
- N-Acetylcysteine and Other Sulfur-Donors as a Preventative and Adjunct Therapy for COVID-19.Advances in pharmacological and pharmaceutical sciences · 2022Review
- Sodium thiosulfate, a source of hydrogen sulfide, stimulates endothelial cell proliferation and neovascularization.Frontiers in cardiovascular medicine · 2022Article
- AB569, a Novel, Topical Bactericidal Gel Formulation, Kills Pseudomonas aeruginosa and Promotes Wound Healing in a Murine Model of Burn Wound Infection.Infection and immunity · 2021Article
- Biological Connection of Psychological Stress and Polytrauma under Intensive Care: The Role of Oxytocin and Hydrogen Sulfide.International journal of molecular sciences · 2021Review
- Hydrogen Sulfide Metabolite, Sodium Thiosulfate: Clinical Applications and Underlying Molecular Mechanisms.International journal of molecular sciences · 2021Review
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 1 country.
Funding
Abstract
STUDY
objectiveThe 2 antidotes for acute cyanide poisoning in the United States must be administered by intravenous injection. In the out-of-hospital setting, intravenous injection is not practical, particularly for mass casualties, and intramuscular injection would be preferred. The purpose of this study is to determine whether sodium nitrite and sodium thiosulfate are effective cyanide antidotes when administered by intramuscular injection.
methodsWe used a randomized, nonblinded, parallel-group study design in 3 mammalian models: cyanide gas inhalation in mice, with treatment postexposure; intravenous sodium cyanide infusion in rabbits, with severe hypotension as the trigger for treatment; and intravenous potassium cyanide infusion in pigs, with apnea as the trigger for treatment. The drugs were administered by intramuscular injection, and all 3 models were lethal in the absence of therapy.
resultsWe found that sodium nitrite and sodium thiosulfate individually rescued 100% of the mice, and that the combination of the 2 drugs rescued 73% of the rabbits and 80% of the pigs. In all 3 species, survival in treated animals was significantly better than in control animals (log rank test, P<.05). In the pigs, the drugs attenuated an increase in the plasma lactate concentration within 5 minutes postantidote injection (difference: plasma lactate, saline solution-treated versus nitrite- or thiosulfate-treated 1.76 [95% confidence interval 1.25 to 2.27]).
conclusionWe conclude that sodium nitrite and sodium thiosulfate administered by intramuscular injection are effective against severe cyanide poisoning in 3 clinically relevant animal models of out-of-hospital emergency care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.