Intravenous Cobinamide, a Novel Cyanide Antidote, versus Hydroxocobalamin in the Treatment of Acute Cyanide Toxicity and Apnea in a Swine (Sus scrofa) Model
Abstract
Compare time to breathing between 3 groups of swine (11/group) with cyanide(CN) induced apnea; treated with intravenous(IV) hydroxocobalamin(HOC), IV cobinamide(COB), or IV normal saline(NS) control. Method:33 swine(45-55kg) intubated, anesthetized & instrumented (MAP and cardiac output). Isoflurane low to allow breathing; room air(0.21FiO2). CN infused until apnea. Given HOC(65mg/kg), COB(12.5mg/kg) or NS(20ml) & monitored 60min. Results:Weight, time to apnea, & CN dose similar (p>0.10). At treatment, blood CN, lactate levels, & decrease in MAP similar (p>0.10). 2/11 swine in NS group survived(p<0.001), compared to 10/11 in HOC & 10/11 in COB group. Time to breaths post treatment similar(HOC 1:48min, COB 1:49min). Blood CN levels undetectable post HOC or COB infusion. No statistically significant differences were detected between groups for CO, MAP, RR, or min vent at 60min. Lactate, pH, and PCO2 at 60 min were similar (p>0.10). Conclusion: IV COB led to similar time to breathing as IV HOC for CN induced apnea and severe toxicity. Cobinamide was 5 times as potent as hydroxocobalamin.
Document Details
- Document Type
- Technical Report
- Publication Date
- Feb 12, 2013
- Accession Number
- ADA587227
Entities
People
- David Tanen
- Gerry Boss
- Maria G. Castaneda
- Susan M. Boudreau
- Vikhyat S Bebarta
Organizations
- 59th Medical Wing