TY  - JOUR
PY  - 2020//
TI  - Intramuscular cobinamide as an antidote to methyl mercaptan poisoning
JO  - Inhalation toxicology
A1  - Hendry-Hofer, Tara B.
A1  - Ng, Patrick C.
A1  - McGrath, Alison M.
A1  - Soules, Kirsten
A1  - Mukai, David S.
A1  - Chan, Adriano
A1  - Maddry, Joseph K.
A1  - White, Carl W.
A1  - Lee, Jangwoen
A1  - Mahon, Sari B.
A1  - Brenner, Matthew
A1  - Boss, Gerry R.
A1  - Bebarta, Vikhyat S.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0895-8378
UR  - http://dx.doi.org/10.1080/08958378.2020.1866123
ID  - ref1
ER  -