Confirmed cases of childhood exposure to cyanide are rare despite multiple potential sources including inhalation of fire smoke, ingestion of toxic household and workplace substances, and ingestion of cyanogenic foods. Because of its infrequent occurrence, medical professionals may have difficulty recognizing cyanide poisoning, confirming its presence, and treating it in pediatric patients. The sources and manifestations of acute cyanide poisoning seem to be qualitatively similar between children and adults, but children may be more vulnerable than adults to poisoning from some sources. The only currently available antidote in the United States (the cyanide antidote kit) has been used successfully in children but has particular risks associated with its use in pediatric patients. Because hemoglobin kinetics vary with age, methemoglobinemia associated with nitrite-based antidotes may be excessive at standard adult dosing in children. A cyanide antidote with a better risk/benefit ratio than the current agent available in the United States is desirable. The vitamin B12 precursor hydroxocobalamin, which has been used in Europe, may prove to be an attractive alternative to the cyanide antidote kit for pediatric patients. In this article we review the available data on the sources, manifestations, and treatment of acute cyanide poisoning in children and discuss unmet needs in the management of pediatric cyanide poisoning.
Skip Nav Destination
Article navigation
November 2006
State-of-the-Art Review Articles|
November 01 2006
Pediatric Cyanide Poisoning: Causes, Manifestations, Management, and Unmet Needs
Robert J. Geller, MD;
Robert J. Geller, MD
aDepartment of Pediatrics and the Medical Toxicology Fellowship Program, Emory University School of Medicine, Atlanta, Georgia
bGeorgia Poison Center, Atlanta, Georgia
Search for other works by this author on:
Claudia Barthold, MD;
Claudia Barthold, MD
aDepartment of Pediatrics and the Medical Toxicology Fellowship Program, Emory University School of Medicine, Atlanta, Georgia
bGeorgia Poison Center, Atlanta, Georgia
Search for other works by this author on:
Jane A. Saiers, PhD;
Jane A. Saiers, PhD
cThe WriteMedicine, Inc, Chapel Hill, North Carolina
Search for other works by this author on:
Alan H. Hall, MD
Alan H. Hall, MD
dToxicology Consulting and Medical Translating Services, Inc, Elk Mountain, Wyoming
eDepartment of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado
Search for other works by this author on:
Address correspondence to Robert J. Geller, MD, Georgia Poison Center, Grady Health System, 80 Jesse Hill Jr Dr SE, Box 26066, Atlanta, GA 30303-3050. E-mail: [email protected]
Pediatrics (2006) 118 (5): 2146–2158.
Article history
Accepted:
June 12 2006
Citation
Robert J. Geller, Claudia Barthold, Jane A. Saiers, Alan H. Hall; Pediatric Cyanide Poisoning: Causes, Manifestations, Management, and Unmet Needs. Pediatrics November 2006; 118 (5): 2146–2158. 10.1542/peds.2006-1251
Download citation file:
Sign in
Don't already have an account? Register
Purchased this content as a guest? Enter your email address to restore access.
Please enter valid email address.
Pay-Per-View Access
$35.00
Comments