{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T08:17:31Z","timestamp":1791361051897,"version":"4.3.1"},"reference-count":26,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,8,9]],"date-time":"2017-08-09T00:00:00Z","timestamp":1502236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"U.S. Air Force Office of the Surgeon General"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hydrogen sulfide (H<jats:sub>2<\/jats:sub>S) is a potentially deadly gas that naturally occurs in petroleum and natural gas. The Occupational Health and Safety Administration cites H<jats:sub>2<\/jats:sub>S as a leading cause of workplace gas inhalation deaths. Mass casualties of H<jats:sub>2<\/jats:sub>S toxicity may be caused by exposure from industrial accidents or release from oil field sites. H<jats:sub>2<\/jats:sub>S is also an attractive terrorism tool because of its high toxicity and ease with which it can be produced. Several potential antidotes have been proposed for hydrogen sulfide poisoning but none have been completely successful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective was to compare treatment response assessed by the time to spontaneous ventilation among groups of swine with acute H<jats:sub>2<\/jats:sub>S\u2010induced apnea treated with intravenous (<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>) cobinamide (4\u00a0mg\/kg in 0.8 <jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> of 225\u00a0mmol\/L solution), <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> hydroxocobalamin (4\u00a0mg\/kg in 5\u00a0<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content> of saline), or saline alone.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010four swine (45\u201355 kg) were anesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. After stabilization, anesthesia was adjusted such that animals would spontaneously ventilate with an FiO<jats:sub>2<\/jats:sub> of 0.21. Sodium hydrosulfide (Na<jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>; concentration of 8\u00a0mg\/<jats:styled-content style=\"fixed-case\">mL<\/jats:styled-content>) was begun at 1 mg\/kg\/min until apnea was confirmed for 20 seconds by capnography. This infusion rate was sustained for 1.5 minutes postapnea and then decreased to a maintenance rate for the remainder of the study to replicate sustained clinical exposure. Animals were randomly assigned to receive cobinamide (4 mg\/kg), hydroxocobalamin (4 mg\/kg), or saline and monitored for 60 minutes beginning 1\u00a0minute postapnea. G* power analysis using the Z\u2010test determined that equal group sizes of eight animals were needed to achieve a power of 80% in detecting a 50% difference in return to spontaneous ventilations at \u03b1\u00a0=\u00a00.05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in baseline variables. Moreover, there were no significant differences in the mg\/kg dose of Na<jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content> (5.6 mg\/kg; p\u00a0=\u00a00.45) required to produce apnea. Whereas all of the cobinamide\u2010treated animals survived (8\/8), none of the control (0\/8) or hydroxocobalamin (0\/8)\u2010treated animals survived. Mean (\u00b1<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>) time to spontaneous ventilation in the cobinamide\u2010treated animals was 3.2 (\u00b11.1) minutes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Cobinamide successfully rescued the severely Na<jats:styled-content style=\"fixed-case\">HS<\/jats:styled-content>\u2010poisoned swine from apnea in the absence of assisted ventilation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13213","type":"journal-article","created":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T16:03:30Z","timestamp":1493913810000},"page":"1088-1098","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Efficacy of Intravenous Cobinamide Versus Hydroxocobalamin or Saline for Treatment of Severe Hydrogen Sulfide Toxicity in a Swine (<i>Sus scrofa<\/i>) Model"],"prefix":"10.1111","volume":"24","author":[{"given":"Vikhyat S.","family":"Bebarta","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine University of Colorado Denver\u2013Anschutz Medical Campus Aurora CO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Normalynn","family":"Garrett","sequence":"additional","affiliation":[{"name":"CREST Research Program Department of Emergency Medicine San Antonio Military Medical Center San Antonio TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Brenner","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute and Medical Clinic University of California at Irvine Irvine CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari B","family":"Mahon","sequence":"additional","affiliation":[{"name":"Beckman Laser Institute and Medical Clinic University of California at Irvine Irvine CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph K.","family":"Maddry","sequence":"additional","affiliation":[{"name":"Air Force En Route Care Research Center San Antonio TX"},{"name":"CREST Research Program Department of Emergency Medicine San Antonio Military Medical Center San Antonio TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Boudreau","sequence":"additional","affiliation":[{"name":"CREST Research Program Department of Emergency Medicine San Antonio Military Medical Center San Antonio TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Castaneda","sequence":"additional","affiliation":[{"name":"CREST Research Program Department of Emergency Medicine San Antonio Military Medical Center San Antonio TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerry R.","family":"Boss","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California at San Diego La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,8,9]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/1476-069X-13-82"},{"key":"e_1_2_7_3_1","unstructured":"Hydrogen Sulfide.2011. Available at:https:\/\/www.osha.gov\/SLTC\/hydrogensulfide\/hazards.htmlAccessed Jan 16 2014."},{"key":"e_1_2_7_4_1","unstructured":"Chemical Terrorism Fact Sheet: Blood Gas Agents \u2010 Hydrogen Sulfide.2002. Available at:http:\/\/biosecurity.slu.edu\/Accessed Jan 14 2014."},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0000000000000065"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2016.9.32267"},{"key":"e_1_2_7_7_1","first-page":"300","article-title":"Suicide fads: frequency and characteristics of hydrogen sulfide suicides in the United States","volume":"12","author":"Reedy SJ","year":"2011","journal-title":"West J Emerg Med"},{"key":"e_1_2_7_8_1","unstructured":"Advisory New York State Office of Homeland Security.2008. Available at:http:\/\/info.publicintelligence.net\/NYhydrogensulfide.pdfAccessed Jan 16 2014."},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.proeng.2011.11.2380"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.02.009"},{"key":"e_1_2_7_11_1","unstructured":"StricklandJ CummingsA SpinnatoJ LiccioneJ FouremanG.Toxicological Review of Hydrogen Sulfide (CAS No. 7783\u201006\u20104). U.S.Environmental Protection Agency 2003. 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