Skip to main content

Cyanide: Hydrogen Cyanide, Inorganic Cyanide Salts, and Nitriles

  • Reference work entry
  • First Online:
Critical Care Toxicology

Abstract

Failure to administer antidotal therapy rapidly when cyanide poisoning seems a likely possibility

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 338.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ballantyne B, Marrs TC. Post-mortem features and criteria for the diagnosis of acute lethal cyanide poisoning. In: Ballantyne B, Marrs TC, editors. Clinical and experimental toxicology of cyanides. Bristol: IOP Publishing; 1987. p. 217–47.

    Google Scholar 

  2. Dugard PH. The absorption of cyanide through human skin in vitro from solutions of sodium cyanide and gaseous HCN. In: Ballantyne B, Marrs TC, editors. Clinical and experimental toxicology of cyanides. Bristol: IOP Publishing; 1987. p. 127–37.

    Google Scholar 

  3. Levine MS, Radford EP. Occupational exposures to cyanide in Baltimore fire fighters. J Occup Med. 1978;20:53–6.

    Article  CAS  PubMed  Google Scholar 

  4. Jones J, McMullen J, Dougherty J. Toxic smoke inhalation: cyanide poisoning in fire victims. Am J Emerg Med. 1987;5:318–21.

    Google Scholar 

  5. Wetherell HR. The occurrence of cyanide in the blood of fire victims. J Forensic Sci. 1966;11:167–73.

    CAS  PubMed  Google Scholar 

  6. Ballantyne B. Hydrogen cyanide as a product of combustion and a factor in morbidity and mortality from fires. In: Ballantyne B, Marrs TC, editors. Clinical and experimental toxicology of cyanides. Bristol: IOP Publishing; 1987. p. 248–91.

    Google Scholar 

  7. Peden NR, Taha A, McSorley PD, et al. Industrial exposure to hydrogen cyanide: Implications for treatment. BMJ (Clin Res). 1986;293:538.

    Article  CAS  Google Scholar 

  8. Barcroft J. The toxicity of atmospheres containing hydrocyanic acid gas. J Hyg. 1931;31:1–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Bonsall JL. Survival without sequelae following exposure to 500 mg/m3 of hydrogen cyanide. Hum Toxicol. 1984;3:57–60.

    Article  CAS  PubMed  Google Scholar 

  10. Drinker P. Hydrocyanic acid gas poisoning by absorption through the skin. J Ind Hyg. 1932;14:1–2.

    Google Scholar 

  11. Walton DC, Witherspoon MG. Skin absorption of certain gases. J Pharmacol Exp Ther. 1926;26:315–24.

    Google Scholar 

  12. McKelway JI. Three cases of poisoning by potassium cyanide. Am J Med Sci. 1905;129:684–8.

    Article  Google Scholar 

  13. Ballantyne B: Comparative acute toxicity of hydrogen cyanide and its salts. In Lindstrom RE, editor. Proceedings of the fourth annual chemical defense bioscience review. Aberdeen Proving Ground, Harford County: Army Medical Research Institute of Chemical Defense; 1984.

    Google Scholar 

  14. Vesey CJ, Wilson J. Red cell cyanide. J Pharm Pharmacol. 1978;30:20–6.

    Article  CAS  PubMed  Google Scholar 

  15. McMillan DE, Svoboda AC. The role of erythrocytes in cyanide detoxification. J Pharmacol Exp Ther. 1982;221:37–42.

    CAS  PubMed  Google Scholar 

  16. Schulz V. Clinical pharmacokinetics of nitroprusside, cyanide, thiosulphate and thiocyanate. Clin Pharmacokinet. 1984;9:239–51.

    Article  CAS  PubMed  Google Scholar 

  17. Schulz V, Bonn R, Kindler J. Kinetics of elimination of thiocyanate in 7 healthy subjects and 8 subjects with renal failure. Klin Wochenschr. 1979;57:243–7.

    Article  CAS  PubMed  Google Scholar 

  18. Sorbo B. Thiosulfate sulfurtransferase and mercaptopyruvate sulfurtransferase. In: Greenberg DM, editor. Metabolic pathways, Metabolism of sulfur compounds, vol. VII. New York: Academic; 1975. p. 433–56.

    Google Scholar 

  19. Westley J, Adler A, Westley L, et al. The sulfur transferases. Fundam Appl Toxicol. 1983;3:377–82.

    Article  CAS  PubMed  Google Scholar 

  20. Ballantyne B. Toxicology of cyanides. In: Ballantyne B, Marrs TC, editors. Clinical and experimental toxicology of cyanides. Bristol: IOP Publishing; 1987. p. 41–126.

    Google Scholar 

  21. Way JL, Sylvester D, Morgan RL, et al. Recent perspectives on the toxicodynamic basis of cyanide antagonism. Fundam Appl Toxicol. 1984;4:S231–9.

    Article  CAS  PubMed  Google Scholar 

  22. Vennesland B, Castric PA, Conn EE, et al. Cyanide metabolism. Fed Proc. 1982;41:2639–48.

    CAS  PubMed  Google Scholar 

  23. Piantadosi CA, Sylvia AL. Cerebral cytochrome a, a3 inhibition by cyanide in bloodless rats. Toxicology. 1984;33:67–79.

    Article  CAS  PubMed  Google Scholar 

  24. Thompson JP, Marrs TC. Hydroxocobalamin in cyanide poisoning. Clin Toxicol. 2012;50:875–85.

    Article  CAS  Google Scholar 

  25. Cole PV, Vesey CJ. Sodium thiosulphate decreases blood cyanide concentrations after the infusion of sodium nitroprusside. Br J Anaesth. 1987;59:531–5.

    Article  CAS  PubMed  Google Scholar 

  26. Hartung R. Cyanides and nitriles. In: Clayton GD, Clayton FE, editors. Patty’s industrial hygiene and toxicology, vol II, part D. 4th ed. New York: Wiley; 1994. p. 3119–72.

    Google Scholar 

  27. Solomonson LP. Cyanide as a metabolic inhibitor. In: Vennesland B, Conn EE, Knowles CJ, et al., editors. Cyanide in biology. London: Academic; 1981. p. 11–28.

    Google Scholar 

  28. Tsubaki M. Fourier-transform infrared study of cyanide binding to the Fea3-CuB binuclear site of bovine heart cytochrome c oxidase: Implication of the redox-linked conformational change at the binuclear site. Biochemistry. 1993;32:164–73.

    Article  CAS  PubMed  Google Scholar 

  29. Way JL. Cyanide intoxication and its mechanism of antagonism. Annu Rev Pharmacol. 1984;24:451–81.

    Article  CAS  Google Scholar 

  30. Tursky T, Sajter V. The influence of potassium cyanide poisoning on the aminobutyric acid level in rat brain. J Neurochem. 1962;9:519–23.

    Article  CAS  PubMed  Google Scholar 

  31. Krebs HG, Woods HG, Alberti KGMM. Hyperlactataemia and lactic acidosis. Essays Med Biochem. 1975;1:81–103.

    CAS  Google Scholar 

  32. Mizock BA. Lactic acidosis. Dis Mon. 1989;35:233–300.

    Article  CAS  PubMed  Google Scholar 

  33. Zilva JF. The origin of acidosis in hyperlactataemia. Ann Clin Biochem. 1978;15:40–3.

    Article  CAS  PubMed  Google Scholar 

  34. Mizock BA. Controversies in lactic acidosis. JAMA. 1987;258:497–501.

    Article  CAS  PubMed  Google Scholar 

  35. Johnston DG, Alberti KGMM. Acid–base balance in metabolic acidoses. Clin Endocrinol Metab. 1983;12:267–85.

    Article  CAS  PubMed  Google Scholar 

  36. Madias NE. Lactic acidosis. Kidney Int. 1986;29:752–74.

    Article  CAS  PubMed  Google Scholar 

  37. Kraut JA, Madias NE. Lactic acidosis. N Engl J Med. 2014;371:2309–19.

    Article  PubMed  CAS  Google Scholar 

  38. Ballantyne B. An experimental assessment of the diagnostic potential of histochemical and biochemical methods for cytochrome oxidase in acute cyanide poisoning. Cell Mol Biol. 1977;22:109–23.

    CAS  Google Scholar 

  39. National Institute for Occupational Safety and Health: Criteria for a recommended standard for occupational exposure to hydrogen cyanide and cyanide salts. NTIS PB-266-230. NIOSH, U.S. Department of Health, Education, and Welfare, Washington, DC, 1976.

    Google Scholar 

  40. DeBush RF, Seidl LG. Attempted suicide by cyanide. Calif Med. 1969;110:394–6.

    Google Scholar 

  41. Graham DL, Laman D, Theodore J, et al. Acute cyanide poisoning complicated by lactic acidosis and pulmonary edema. Arch Intern Med. 1977;137:1051–5.

    Article  CAS  PubMed  Google Scholar 

  42. Miller MH, Toops TC. Acute cyanide poisoning: recovery with sodium thiosulfate therapy. J Indiana State Med Assoc. 1951;44:1164.

    CAS  PubMed  Google Scholar 

  43. Wexler J, Whittenberger JL, Dumke PR. The effect of cyanide on the electrocardiogram of man. Am Heart J. 1947;34:163–73.

    Article  CAS  PubMed  Google Scholar 

  44. Carmelo S. New contributions to the study of subacute-chronic hydrocyanic acid intoxication in man. Rass Med Ind. 1955;24:254–71.

    Google Scholar 

  45. Brivet F, Delfraissy JF, Duche M, et al. Acute cyanide poisoning: recovery with non-specific supportive therapy. Intensive Care Med. 1983;9:33–5.

    Article  CAS  PubMed  Google Scholar 

  46. Gill JR, Marker E, Stajic M. Suicide by cyanide: 17 deaths. J Forensic Sci. 2004;49:826–8.

    CAS  PubMed  Google Scholar 

  47. Tovo S. Poisoning due to KCN absorbed through skin. Minerva Med. 1955;75:158–61.

    CAS  Google Scholar 

  48. Uitti RJ, Rajput AH, Ashenhurst EM, et al. Cyanide-induced parkinsonism: a clinicopathologic report. Neurology. 1985;35:921–5.

    Article  CAS  PubMed  Google Scholar 

  49. Peters CG, Mundy JVB, Rayner PR. Acute cyanide poisoning. Anaesthesia. 1982;37:582–6.

    Article  CAS  PubMed  Google Scholar 

  50. Hall AH, Rumack B. Clinical toxicology of cyanide. Ann Emerg Med. 1986;15:1067–74.

    Article  CAS  PubMed  Google Scholar 

  51. Shragg TA, Albertson TE, Fisher CJ. Cyanide poisoning after bitter almond ingestion. West J Med. 1982;136:65–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  52. Johnson RP, Mellors JW. Arteriolarization of venous blood gases: a clue to the diagnosis of cyanide poisoning. J Emerg Med. 1988;6:401–4.

    Article  CAS  PubMed  Google Scholar 

  53. Buchanan IS, Dhamee MS, Griffiths FED, et al. Abnormal fundal appearances in a case of poisoning by a cyanide capsule. Med Sci Law. 1976;16:29–32.

    Article  CAS  PubMed  Google Scholar 

  54. Wesson DE, Foley R, Sabatini S, et al. Treatment of acute cyanide intoxication with hemodialysis. Am J Nephrol. 1985;5:121–6.

    Article  CAS  PubMed  Google Scholar 

  55. Lasch EE, El Shawa R. Multiple cases of cyanide poisoning by apricot kernels in children from Gaza. Pediatrics. 1981;68:5–7.

    CAS  Google Scholar 

  56. Hall AH, Rumack BH, Schaffer MI, et al. Clinical toxicology of cyanide: North American clinical experiences. In: Ballantyne B, Marrs TC, editors. Clinical and experimental toxicology of cyanides. Bristol: IOP Publishing; 1987. p. 312–33.

    Google Scholar 

  57. Vesey CJ, Krapez JR, Cole PV. The effects of sodium nitroprusside and cyanide on haemoglobin function. J Pharm Pharmacol. 1980;32:256–61.

    Article  CAS  PubMed  Google Scholar 

  58. Curry SC, Patrick HC. Lack of evidence of a percent saturation gap in cyanide poisoning. Ann Emerg Med. 1991;20:523–8.

    Article  CAS  PubMed  Google Scholar 

  59. Ballantyne B. Artifacts in the definition of toxicity by cyanides and cyanogens. Fundam Appl Toxicol. 1983;3:400–8.

    Article  CAS  PubMed  Google Scholar 

  60. Pasch T, Schulz V, Hoppelshauser G. Nitroprusside-induced formation of cyanide and its detoxication with thiosulfate during deliberate hypotension. J Cardiovasc Pharmacol. 1983;5:77–85.

    Article  CAS  PubMed  Google Scholar 

  61. Wilson J, Mathews DM. Metabolic inter-relationships between cyanide, thiocyanate and vitamin B12 in smokers and non-smokers. Clin Sci. 1966;31:1–7.

    CAS  PubMed  Google Scholar 

  62. Cottrell JE, Casthely P, Brodie J, et al. Prevention of nitroprusside-induced cyanide toxicity with hydroxocobalamin. N Engl J Med. 1978;298:809–11.

    Article  CAS  PubMed  Google Scholar 

  63. Vesey CJ, Cole PV. Blood cyanide and thiocyanate concentrations produced by long-term therapy with sodium nitroprusside. Br J Anaesth. 1985;57:148–55.

    Article  CAS  PubMed  Google Scholar 

  64. Ballantyne B. In vitro production of cyanide in normal human blood and the influence of thiocyanate and storage temperature. Clin Toxicol. 1977;11:173–93.

    Article  CAS  PubMed  Google Scholar 

  65. Troup CM, Ballantyne B. Analysis of cyanide in biological fluids and tissues. In: Ballantyne B, Marrs TC, editors. Clinical and experimental toxicology of cyanides. Bristol: IOP Publishing; 1987. p. 22–37.

    Google Scholar 

  66. Curry SC. Methemoglobinemia. Ann Emerg Med. 1982;11:214–21.

    Article  CAS  PubMed  Google Scholar 

  67. Chen KK, Rose CL. Nitrite and thiosulfate therapy in cyanide poisoning. JAMA. 1952;149:113–9.

    Article  CAS  Google Scholar 

  68. Kiese M, Weger N. Formation of ferrihaemoglobin with aminophenols in the human for the treatment of cyanide poisoning. Eur J Pharmacol. 1969;7:97–105.

    Article  CAS  PubMed  Google Scholar 

  69. Vogel SN, Sultan TR, Ten Eyck RP. Cyanide poisoning. Clin Toxicol. 1981;18:367–83.

    Article  CAS  PubMed  Google Scholar 

  70. Berlin CM. The treatment of cyanide poisoning in children. Pediatrics. 1970;46:793–6.

    PubMed  Google Scholar 

  71. Moser P. Zur wirkung von nitrit auf rote blutzellen des menschen. Arch Exp Pathol Pharmakol. 1950;210:60–70.

    CAS  Google Scholar 

  72. Hall AH, Doutre WH, Ludden T, et al. Nitrite/thiosulfate treated acute cyanide poisoning: estimated kinetics after antidote. J Toxicol Clin Toxicol. 1987;25:121–33.

    Article  CAS  PubMed  Google Scholar 

  73. Way JL, Leung P, Sylvester DM, et al. Methaemoglobin formation in the treatment of acute cyanide intoxication. In: Ballantyne B, Marrs TC, editors. Clinical and experimental toxicology of cyanides. Bristol: IOP Publishing; 1987. p. 402–12.

    Google Scholar 

  74. Pearce LL, Manzano EL, Bosch-Martinez S, et al. Antagonism of nitric oxide toward the inhibition of cytochrome c oxidase by carbon monoxide and cyanide. Chem Res Toxicol. 2008;21:2073–81.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Pearce LL, Bominaar EL, Hill BC, et al. Reversal of cyanide inhibition of cytochrome c oxidase by the auxiliary substrate nitric oxide: an endogenous antidote to cyanide poisoning? J Biol Chem. 2003;278:52139–45.

    Article  CAS  PubMed  Google Scholar 

  76. Cambal LK, Swanson MR, Yuan Q, et al. Acute, sublethal cyanide poisoning in mice is ameliorated by nitrite alone: complications arising from concomitant administration of nitrite and thiosulfate as an antidotal combination. Chem Res Toxicol. 2011;24:1104–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Kruszyna R, Kruszyna H, Smith RP. Comparison of hydroxylamine, 4-dimethylaminophenol and nitrite protection against cyanide poisoning in mice. Arch Toxicol. 1982;49:191–202.

    Article  CAS  PubMed  Google Scholar 

  78. Chen KK, Rose RL, Clowes GHA. Methylene blue (methylthionine chloride), nitrites and sodium thiosulphate against cyanide poisoning. Proc Soc Exp Biol Med. 1933;31:250–1.

    Article  Google Scholar 

  79. Gurrows GE, Way JL: Antagonism of cyanide toxicity by phenoxybenzamine (Abstract). Fed Proc. 1975;36:534.

    Google Scholar 

  80. Way JL, Burrows GE. Cyanide intoxication: protection with chlorpromazine. Toxicol Appl Pharmacol. 1976;36:1–5.

    Article  Google Scholar 

  81. Houeto P, Borron SW, Sandouk P, Imbert M, Levillain P, Baud FJ. Pharmacokinetics of hydroxocobalamin in smoke inhalation victims. J Toxicol Clin Toxicol. 1996;34:397–404.

    Article  CAS  PubMed  Google Scholar 

  82. Borron SW, Stonerook M, Reid F. Efficacy of hydroxocobalamin for the treatment of acute cyanide poisoning in adult beagle dogs. Clin Toxicol. 2006;44:5–15.

    Article  CAS  Google Scholar 

  83. Bebarta VS, Pitotti RL, Dixon PS, et al. Hydroxocobalamin and epinephrine both improve survival in a swine model of cyanide-induced cardiac arrest. Ann Emerg Med. 2012;60:415–22.

    Article  PubMed  Google Scholar 

  84. Bebarta VS, Piotti RL, Dixon P, et al. Hydroxocobalamin versus sodium thiosulfate for the treatment of acute cyanide toxicity in a swine (sus serofa) model. Ann Emerg Med. 2012;59:532–9.

    Article  PubMed  Google Scholar 

  85. Bebarta VS, Tanen DA, Lairet J, et al. Hydroxocobalamin and sodium thiosulfate verses sodium nitrite and sodium thiosulfate in the treatment of acute cyanide toxicity in a swine (sus scrofa) model. Ann Emerg Med. 2010;55:345–51.

    Article  PubMed  Google Scholar 

  86. Borron SW, Baud FJ, Megarbane B, et al. Severe acute cyanide poisoning by ingestion or inhalation. Am J Emerg Med. 2007;25:551–8.

    Article  PubMed  Google Scholar 

  87. Borron SW, Baud FJ, Barriot P, et al. Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann Emerg Med. 2007;49:794–801.

    Article  PubMed  Google Scholar 

  88. Fortin JL, Giocanti JP, Ruttimann M, et al. Prehospital administration for smoke inhalation-associated cyanide poisoning: 8 years of experience in the Paris Fire Brigade. Clin Toxicol. 2006;44:37–44.

    Article  CAS  Google Scholar 

  89. Heitzman J, Shen Q, Cazares J, et al. Hydroxocobalamin colored plasma. Transfusion Medicine Illustrated. Transfusion. 2009;49:2555–6.

    Article  PubMed  Google Scholar 

  90. Curry SC, Connor DA, Raschke RA. Effect of the cyanide antidote hydroxocobalamin on commonly ordered serum chemistry studies. Ann Emerg Med. 1994;24:65–7.

    Article  CAS  PubMed  Google Scholar 

  91. Carlsson CJ, Hansen HE, Hilsted L, et al. An evaluation of the interference of hydroxocobalamin with chemistry and co-oximetry tests on nine commonly used instruments. Scand J Clin Lab Invest. 2011;71:378–86.

    Article  CAS  PubMed  Google Scholar 

  92. Lee J, Mukai D, Kreuter K, et al. Potential interference by hydroxocobalamin on cooximetry hemoglobin measurements during cyanide and smoke inhalation treatments. Ann Emerg Med. 2007;49:802–5.

    Article  PubMed  Google Scholar 

  93. Pace R, Homme MB, Hoffman RS, et al. Effects of hydroxocobalamin on carboxyhemoglobin measured under physiologic and pathologic conditions. Clin Toxicol. 2014;52:647–50.

    Article  CAS  Google Scholar 

  94. Livshits Z, Lugassy DM, Shawn LK, Hoffman RS. Falsely low carboxyhemoglobin level after hydroxocobalamin therapy. N Engl J Med. 2012;367:1270–1.

    Article  CAS  PubMed  Google Scholar 

  95. Sutter M, Tereshchenko N, Rafii R, et al. Hemodialysis complications after hydroxocobalamin: a case report. J Med Toxicol. 2010;6:165–7.

    Article  PubMed  PubMed Central  Google Scholar 

  96. Way JL, End E, Sheehy MH, et al. Effect of oxygen on cyanide intoxication: IV. Hyperbaric oxygen. Toxicol Appl Pharmacol. 1972;22:415–21.

    Article  CAS  PubMed  Google Scholar 

  97. Dodds C, McKnight C. Cyanide toxicity after immersion and the hazards of dicobalt edetate. BMJ (Clin Res). 1985;291:785–6.

    Article  CAS  Google Scholar 

  98. Bebarta VS, Tanen DA, Boudreau S, et al. Intravenous cobinamide verses hydroxocobalamin for acute treatment of severe cyanide poisoning in a swine (sus scrofa) model. Ann Emerg Med. 2014;64:612–9.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Nagasawa HT, Goon DJ, Crankshaw DL, Vince R, Patterson SE. Novel, orally effective cyanide antidotes. J Med Chem. 2007;50:6462–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Weger NP. Treatment of cyanide poisoning with 4-dimethylamino-phenol (DMAP) – experimental and clinical overview. Fundam Appl Toxicol. 1983;3:387–96.

    Article  CAS  PubMed  Google Scholar 

  101. Kerger H, Dodidou P, Passani-Kruppa D, et al. Excessive methaemoglobinaemia and multi-organ failure following 4-DMAP antidote therapy. Resuscitation. 2005;66:231–4.

    Article  PubMed  Google Scholar 

  102. Berumen Jr U. Dog poisons man. JAMA. 1983;249:353.

    Article  PubMed  Google Scholar 

  103. Available from http://www.cyanokit.com/pdf/CYANOKIT_Perscribing_Information_5-06-2011.pdf. Package insert; Internet; Accessed 4 Dec 2014.

  104. Pettigrew AR, Logan RW, Willocks J. Smoking in pregnancy – effects on birth weight and on cyanide and thiocyanate levels in mother and baby. Br J Obstet Gynaecol. 1977;84:31–4.

    Article  CAS  PubMed  Google Scholar 

  105. Pelclova D, Kredba V, Pokorna P, et al. Sodium nitrite intoxication in a newborn (Abstract). J Toxicol Clin Toxicol. 2002;40:352–3.

    Google Scholar 

  106. Graeme KA, Curry SC, Bikin DS, et al. Lack of transplacental movement of the cyanide antidote, thiosulfate, in gravid ewes. Anaesth Analg. 2000;89:1448–52.

    Google Scholar 

  107. Muraki K, Inoue Y, Ohta I, et al. Massive rhabdomyolysis and acute renal failure after acetonitrile exposure. Intern Med. 2001;40:936–9.

    Article  CAS  PubMed  Google Scholar 

  108. Mueller M, Borland C. Delayed cyanide poisoning following acetonitrile ingestion. Postgrad Med J. 1997;73:299–300.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Thier R, Lewalter J, Bolt HM. Species differences in acrylonitrile metabolism and toxicity between experimental animals and humans based on observations in human accidental poisoning. Arch Toxicol. 2000;74:184–9.

    Article  CAS  PubMed  Google Scholar 

  110. Gosselin RE, Hodge HC, Smith RP, Gleason MN. Cyanide. In: Clinical toxicology of commercial products. 4th ed. Baltimore: Williams & Wilkins; 1976. p. 105–12.

    Google Scholar 

  111. Centers for Disease Control: Cyanide poisonings associated with over-the-counter medication – Washington State. MMWR Morb Mortal Wkly Rep. 1991;40:161, 167–8.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Steven C. Curry .

Editor information

Editors and Affiliations

Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition

  1. I

    Evidence obtained from at least one properly randomized controlled trial.

  2. II-1

    Evidence obtained from well-designed controlled trials without randomization.

  3. II-2

    Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.

  4. II-3

    Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.

  5. III

    Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this entry

Cite this entry

Curry, S.C., Spyres, M.B. (2017). Cyanide: Hydrogen Cyanide, Inorganic Cyanide Salts, and Nitriles. In: Brent, J., et al. Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-17900-1_101

Download citation

Publish with us

Policies and ethics