Медицина неотложных состояний (Sep 2022)
Damage of internal organs during intoxication with cyanide compounds
Abstract
Hydrocyanic acid is a weak acid, its aqueous solutions have a faint smell of bitter almonds. Hydrocyanic acid derivatives are called cyanides (potassium cyanide, sodium cyanide). Under production conditions, poisoning with hydrocyanic acid and its compounds is possible due to inhalation of its vapors. Less commonly, they enter the body through the skin and gastrointestinal tract. The toxicity of hydrocyanic acid is explained by the affinity of its molecule for the ferric iron of the tissue respiratory enzyme cytochrome oxidase. Cyanic compounds block it, making it impossible to react with oxygen, resulting in oxygen starvation of tissues — tissue hypoxia. The central nervous system suffers most from hypoxia, in particular, the zones located close to the respiratory center. There are acute and chronic cyanide poisonings. The victim must be removed to clean air. It is necessary to quickly take off contaminated clothing and begin medical assistance. Drug treatment of patients with acute intoxication caused by cyanide compounds is based on three main principles: 1) formation of the so-called barrier in the blood by intravenous administration of methylene blue, as well as by inhalation of amyl nitrite, 2) neutralization of the poison. For this purpose, a large amount of glucose is introduced, which contributes to the formation of harmless compounds — cyanohydrin and sodium thiosulfate, 3) impact on oxidative processes in tissues — carbogen inhalation is started immediately. In the prevention of poisonings, sealing of apparatus and equipment, the use of local exhaust ventilation, the mechanization of production processes, and constant thorough monitoring of the state of air in working rooms are of great importance. If you need to work in contact with vapors of hydrocyanic acid and its compounds, it is mandatory to wear a gas mask.
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