Cyanide Toxicity in Relation to Anesthesia
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Abstract
Cyanide toxicity is a rare but potentially life-threatening complication associated with anesthesia. It disrupts cellular respiration by inhibiting cytochrome oxidase, which is crucial for the utilization of oxygen. This disruption ultimately leads to impaired oxygen consumption and tissue hypoxia. Anesthesia-related cyanide toxicity can occur through various mechanisms, including the metabolism of certain drugs or the inhalation of volatile agents. Its clinical presentation can be nonspecific and may include altered mental status, cardiovascular instability, and metabolic acidosis. Diagnosis can be aided by laboratory tests such as arterial blood gas analysis and serum lactate levels. Treatment of cyanide toxicity involves a multi-pronged approach that includes the administration of specific antidotes like hydroxocobalamin or sodium thiosulfate, as well as supportive measures to maintain oxygenation and hemodynamic stability. Additionally, the offending agent should be removed or discontinued.
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