{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:55:26Z","timestamp":1781502926304,"version":"3.54.1"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>\n                    This article reports a rare and lethal case of cyanide poisoning, aiming to explore its early diagnosis and successful treatment strategies. Upon admission, the patient presented with cardiac and respiratory arrest, deep coma, and severe metabolic acidosis. The core resuscitation measures included early mechanical ventilation, vasoactive drug support, bicarbonate therapy, and the early initiation of continuous blood purification as part of a multimodal strategy. We observed that a combination of elevated central venous partial pressure of carbon dioxide (PvCO\n                    <jats:sub>2<\/jats:sub>\n                    ) and elevated lactate provided potential bedside clues for early suspicion of cyanide poisoning. During treatment, a rise in PvCO\n                    <jats:sub>2<\/jats:sub>\n                    accompanied by a decrease in lactate was noted, which may serve as a hypothesis-generating observation for treatment response, acknowledging the influence of multiple concurrent interventions. The patient recovered substantially after comprehensive treatment. This case provides valuable experience for the treatment of cyanide poisoning.\n                  <\/jats:p>","DOI":"10.3389\/fphar.2026.1837748","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:37:14Z","timestamp":1781501834000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Successful multimodal management of a lethal cyanide poisoning \u2013 insights into the role of early blood purification and potential bedside monitoring indicators"],"prefix":"10.3389","volume":"17","author":[{"given":"Hang","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaqi","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujia","family":"Qu","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tianjin Medical University General Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e523","DOI":"10.1097\/CCM.0000000000003075","article-title":"Determinants of lactic acidosis in acute cyanide poisonings","volume":"46","author":"Baud","year":"2018","journal-title":"Crit. Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1067","DOI":"10.1016\/s0196-0644(86)80131-7","article-title":"Clinical toxicology of cyanide","volume":"15","author":"Hall","year":"1986","journal-title":"Ann. Emerg. Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s13181-018-0688-y","article-title":"A review on ingested cyanide: risks, clinical presentation, diagnostics, and treatment challenges","volume":"15","author":"Hendry-Hofer","year":"2019","journal-title":"J. Med. Toxicol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1016\/0736-4679(88)90014-5","article-title":"Arteriolization of venous blood gases: a clue to the diagnosis of cyanide poisoning","volume":"6","author":"Johnson","year":"1988","journal-title":"J. Emerg. Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1420","DOI":"10.3390\/biom14111420","article-title":"Cyanide and cyanogenic compounds-toxicity, molecular targets, and therapeutic agents","volume":"14","author":"Lachowicz","year":"2024","journal-title":"Biomolecules"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e149","DOI":"10.1161\/CIR.0000000000001161","article-title":"2023 American heart association focused update on the management of patients with cardiac arrest or life-threatening toxicity due to poisoning: an update to the American heart association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care","volume":"2023","author":"Lavonas","year":"2023","journal-title":"Circulation"},{"key":"B7","article-title":"Cyanide toxicity treatment and management","author":"Leybell","year":"2025","journal-title":"Medscape"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e890","DOI":"10.1097\/MD.0000000000000890","article-title":"Acute self-induced poisoning with sodium ferrocyanide and methanol treated with plasmapheresis and continuous renal replacement therapy successfully: a case report","volume":"94","author":"Liu","year":"2015","journal-title":"Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.addr.2015.05.017","article-title":"Developments in extracorporeal therapy for the poisoned patient","volume":"90","author":"Patel","year":"2015","journal-title":"Adv. Drug Deliv. Rev."},{"key":"B10","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1111\/1744-9987.13843","article-title":"Dialysis and extracorporeal therapies for enhanced elimination of toxic ingestions and poisoning","volume":"26","author":"Yaxley","year":"2022","journal-title":"Ther. Apheresis Dial."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1837748\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T05:37:17Z","timestamp":1781501837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1837748\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":10,"alternative-id":["10.3389\/fphar.2026.1837748"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1837748","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"article-number":"1837748"}}