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CASE REPORT
Korean J Pediatr 2010 August;53(8) :805-808.
doi:https://doi.org/10.3345/kjp.2010.53.8.805
Successful treatment by exchange transfusion of a young infant with sodium nitroprusside poisoning
Jong Geun Baek (Baek JG), Hoar Lim Jeong (Jeong HL), Ji Sook Park, (Park, JS), Ji Hyun Seo (Seo JH), Eun Sil Park (Park ES), Jae Young Lim (Lim JY), Chan Hoo Park (Park CH), Hyang Ok Woo (Woo HO), Hee Shang Youn (Youn HS), Jung Sook Yeom (Yeom JS)
Department of Pediatrics, Gyeongsang National University School of Medicine, Jinju, Korea
Corresponding Author: Jung Sook Yeom ,Email: polo96@daum.net
Copyright © 2010 by The Korean Pediatric Society
ABSTRACT
Although sodium nitroprusside (SNP) is often used in pediatric intensive care units, cyanide toxicity can occur after SNP treatment. To treat SNP-induced cyanide poisoning, antidotes such as amyl nitrite, sodium nitrite, sodium thiosulfate, and hydroxycobalamin should be administered immediately after diagnosis. Here, we report the first case of a very young infant whose SNP-induced cyanide poisoning was successfully treated by exchange transfusion. The success of this alternative method may be related to the fact that exchange transfusion not only removes the cyanide from the blood but also activates detoxification systems by supplying sulfur-rich plasma. Moreover, exchange transfusion replaces cyanide-contaminated erythrocytes with fresh erythrocytes, thereby improving the bloods oxygen carrying capacity more rapidly than antidote therapy. Therefore, we believe that exchange transfusion might be an effective therapeutic modality for critical cases of cyanide poisoning.
Keywords: Nitroprusside | Exchange transfusion | Cyanides | Poisoning | Detoxification | Infant
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