TY - JOUR
T1 - Potential therapies for sodium azide intoxication
T2 - a case report and review of the literature
AU - Groeneveld, Nta
AU - van Hoeven, L
AU - van der Crabben, R S
AU - den Uil, C A
AU - Bethlehem, C
AU - Alsma, J
N1 - Publisher Copyright:
© 2022 Rila Publications Ltd.
PY - 2022/6/9
Y1 - 2022/6/9
N2 - Intoxications with sodium azide are rare and in almost all cases lethal in doses above 700 mg or 10mg/kg. We report a case of a patient who ingested 2 grams of sodium azide as a suicide attempt. Sodium azide irreversible blocks cytochrome C oxidase by inhibiting oxidative phosphorylation leading to cell death. There is currently no antidote available. Our patient was treated with a range of therapies, on site, in the emergency department and in the intensive care unit, such as sodium thiosulphate, methylene blue, intralipid, extensive gastric lavage, whole bowel irrigation combined with pro-kinetics, hydroxocobalamin and exchange transfusion. During the clinical course the patient developed cardiac failure, for which veno-arterial ECMO and an intra-aortic balloon pump was placed. However, cardiac function did not recover, leading to discontinuation of treatment after 7 days. As literature on sodium azide intoxication is scarce, we conducted a review to present potential treatment options.
AB - Intoxications with sodium azide are rare and in almost all cases lethal in doses above 700 mg or 10mg/kg. We report a case of a patient who ingested 2 grams of sodium azide as a suicide attempt. Sodium azide irreversible blocks cytochrome C oxidase by inhibiting oxidative phosphorylation leading to cell death. There is currently no antidote available. Our patient was treated with a range of therapies, on site, in the emergency department and in the intensive care unit, such as sodium thiosulphate, methylene blue, intralipid, extensive gastric lavage, whole bowel irrigation combined with pro-kinetics, hydroxocobalamin and exchange transfusion. During the clinical course the patient developed cardiac failure, for which veno-arterial ECMO and an intra-aortic balloon pump was placed. However, cardiac function did not recover, leading to discontinuation of treatment after 7 days. As literature on sodium azide intoxication is scarce, we conducted a review to present potential treatment options.
UR - http://www.scopus.com/inward/record.url?scp=85131704428&partnerID=8YFLogxK
U2 - 10.52964/amja.0903
DO - 10.52964/amja.0903
M3 - Article
C2 - 35681182
SN - 1747-4884
VL - 21
SP - 86
EP - 95
JO - Acute Medicine
JF - Acute Medicine
IS - 2
ER -