• Postgrad Med J · Dec 1989

    Case Reports

    The metabolic effects of fatal cyanide poisoning.

    • B M Singh, N Coles, P Lewis, R A Braithwaite, M Nattrass, and M G FitzGerald.
    • General Hospital, Birmingham, UK.
    • Postgrad Med J. 1989 Dec 1; 65 (770): 923-5.

    AbstractMetabolic and toxicological data were obtained during the first 24 hours following severe and eventually fatal cyanide poisoning. Initial blood cyanide concentrations were 804 mumol/l but fell rapidly over 24 hours following cobalt edetate therapy to 15 mumol/l. However, plasma thiocyanate concentrations rose over 24 hours (147-267 mumol/l) suggesting continued tissue detoxification. The major metabolic abnormality was lactic acidosis (initial pH 7.21, blood lactate 17.5 mmol/l) which corrected over 12 hours. Despite high circulating insulin concentrations the responses of blood glucose, plasma non-esterified fatty acid, blood glycerol and 3-hydroxybutyrate suggested marked insulin resistance.

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