Intravenous versus intramuscular cobinamide compared to intravenous saline (control) in the treatment of acute, survivable, mitochondrial toxins in swine (Sus Scrofa): a pilot study
59th Medical Operations Squadron Lackland AFB United States
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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 mEqL and lactate 1.1 mmolL among the animals. In pigs infused with the highest dose and concentration of NaN3 n14, significant hyperkalemia began at apnea 5.1 mmolL and continued to rise mean 7.7 mmolL 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 mmoL.