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Introduction

Cyanide poisoning is a life-threatening condition resulting from exposure to cyanide, a potent mitochondrial toxin.  Cyanide inhibits oxidative phosphorylation, thereby blocking the production of ATP via aerobic metabolism.  This forces cells to switch to anaerobic metabolism, which leads to lactic acid formation and profound metabolic acidosis.  Early acute toxicity is characterized by nonspecific clinical findings, including confusion, dizziness, headache, and tachycardia.  Clinical decompensation occurs rapidly, resulting in respiratory failure, seizure, coma, and cardiovascular collapse.  Immediate intervention with antidotal therapy and resuscitative measures is necessary to prevent death.

Risk factors

Potential sources of cyanide exposure include:

  • House fires:  Burning of substances such as plastics, wool, silk, and synthetic fibers leads to the production of cyanide gas.
  • Occupational exposure:  Industries like mining, electroplating, metal cleaning, and chemical manufacturing have been associated with cyanide poisoning.

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