Accession Number : AD1049985

Title :   Intravenous versus intramuscular cobinamide compared to intravenous saline (control) in the treatment of acute, survivable, mitochondrial toxins in swine (Sus Scrofa): a pilot study

Descriptive Note : Technical Report

Corporate Author : 59th Medical Operations Squadron Lackland AFB United States

Personal Author(s) : Maddry ,Joseph K ; NG,Patrick C ; Garrett,Normalynn ; Castaneda,Maria G ; Boudreau,Susan M ; Bebarta,Vikhyat S

Full Text :

Report Date : 10 Apr 2018

Pagination or Media Count : 4

Abstract : Sodium azide (NaN3) poisonings are rare but extremely deadly. There is very little in the literature regarding the clinical course of sodium azide poisoning. Virtually all of the information comes from case studies and each of those describe hypokalemia hours after poisoning. Antidotes to cyanide have been used for sodium azide poisonings but have had limited success. The study was not completed, we were still in model development. What we had seen thus far is once the NaN3 infusion had begun, all pigs became hyperkalemic, acidotic and hypotensive. There were no significant differences in baseline vital signs, chemistries, or arterial blood gases including potassium (mean 4.1 mEq/L) and lactate (1.1 mmol/L) among the animals. In pigs infused with the highest dose and concentration of NaN3 (n=14), significant hyperkalemia began at apnea (5.1 mmol/L) and continued to rise (mean 7.7 mmol/L) even after the infusion was discontinued. Swine not treated for hyperkalemia died. Those treated with insulin, dextrose 50 , and calcium survived, but demonstrated elevated T waves on electrocardiogram and continued acidosis (lactate mean 6.7 mmo/L).

Descriptors :   toxicity , hyperkalemia , therapy , medical research , pigs , models , sodium azides , poisoning , sodium compounds

Subject Categories : Toxicology

Distribution Statement : APPROVED FOR PUBLIC RELEASE