Hydroxocobalamin: Improved public health readiness for cyanide disasters
Hydroxocobalamin: Improved public health readiness for cyanide disasters
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DOI：
10.1067/mem.2001.114315
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发表时间：
2001-06-01
影响因子：
6.2
通讯作者：
Keim, ME
中科院分区：
文献类型：
--
作者：
Sauer, SW;Keim, ME
美国一直受到工业事故、危险材料运输事件和蓄意恐怖袭击造成的大规模伤亡氰化物灾难的威胁。目前美国紧急医疗系统对氰化物灾难的准备是糟糕的。作为一个国家，我们根本没有为重大的氰化物相关事件做好准备。氰化物中毒的标准治疗是氰化物解毒剂试剂盒，该试剂盒基于使用亚硝酸盐诱导高铁血红蛋白血症。该套件既昂贵又不适合医院外使用。它也有自己的固有毒性，阻止快速管理。此外，我们的医院经常不储存这种救命的解毒剂，或拒绝储存一种以上。羟钴胺素是公认的有效，安全，易于管理的氰化物解毒剂。由于其极低的不良反应，它是理想的医院外使用的可疑氰化物中毒。为了有效地为氰化物灾难做好准备，美国必须调查、采用、制造和储存羟钴胺素，以防止不必要的发病和死亡。
The United Stales is under the constant threat of a mass casualty cyanide disaster from industrial accidents, hazardous material transportation incidents, and deliberate terrorist attacks. The current readiness for cyanide disaster by the emergency medical system in the United States is abysmal. We, as a nation, are simply not prepared for a significant cyanide-related event. The standard of care for cyanide intoxication is the cyanide antidote kit, which is based on the use of nitrites to induce methemoglobinemia. This kit is both expensive and ill suited for out-of-hospital use. It also has its own inherent toxicity that prevents rapid administration. Furthermore, our hospitals frequently fail to stock this life-saving antidote or decline to stock more than one. Hydroxocobalamin is well recognized as an efficacious, safe, and easily administered cyanide antidote. Because of its extremely low adverse effect profile, it is ideal for out-of-hospital use in suspected cyanide intoxication. To effectively prepare for a cyanide disaster, the United States must investigate, adopt, manufacture, and stockpile hydroxocobalamin to prevent needless morbidity and mortality.