@article{ref1,
title="Intramuscular cobinamide as an antidote to methyl mercaptan poisoning",
journal="Inhalation toxicology",
year="2020",
author="Hendry-Hofer, Tara B. and Ng, Patrick C. and McGrath, Alison M. and Soules, Kirsten and Mukai, David S. and Chan, Adriano and Maddry, Joseph K. and White, Carl W. and Lee, Jangwoen and Mahon, Sari B. and Brenner, Matthew and Boss, Gerry R. and Bebarta, Vikhyat S.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Methyl mercaptan occurs naturally in the environment and is found in a  variety of occupational settings, including the oil, paper, plastics, and pesticides  industries. It is a toxic gas and deaths from methyl mercaptan exposure have  occurred. The Department of Homeland Security considers it a high threat chemical  agent that could be used by terrorists. Unfortunately, no specific treatment exists  for methyl mercaptan poisoning. <br><br>METHODS: We conducted a randomized trial in 12 swine  comparing no treatment to intramuscular injection of the vitamin B(12) analog  cobinamide (2.0 mL, 12.5 mg/kg) following acute inhalation of methyl mercaptan gas. Physiological and laboratory parameters were similar in the control and  cobinamide-treated groups at baseline and at the time of treatment. <br><br>RESULTS: All six  cobinamide-treated animals survived, whereas only one of six control animals lived  (17% survival) (p = 0.0043). The cobinamide-treated animals returned to a normal  breathing pattern by 3.8 ± 1.1 min after treatment (mean ± SD), while all but one  animal in the control group had intermittent gasping, never regaining a normal  breathing pattern. Blood pressure and arterial oxygen saturation returned to  baseline values within 15 minutes of cobinamide-treatment. Plasma lactate  concentration increased progressively until death (10.93 ± 6.02 mmol [mean ± SD]) in  control animals, and decreased toward baseline (3.79 ± 2.93 mmol [mean ± SD]) by the  end of the experiment in cobinamide-treated animals. <br><br>CONCLUSION: We conclude that  intramuscular administration of cobinamide improves survival and clinical outcomes  in a large animal model of acute, high dose methyl mercaptan poisoning.<p /> <p>Language: en</p>",
language="en",
issn="0895-8378",
doi="10.1080/08958378.2020.1866123",
url="http://dx.doi.org/10.1080/08958378.2020.1866123"
}