Preclinical evaluation of injectable reduced hydroxocobalamin as an antidote to acute carbon monoxide poisoning.

Background: Current management of acute inhalational carbon monoxide (CO) toxicity includes hyperbaric or normobaric O2 therapy. However, efficacy has not been established. The purpose of this study was to establish therapeutic proof of concept for a novel injectable antidote consisting of the combination of hydroxocobalamin and ascorbic acid into a reduced form (B12r) as demonstrated by clinically significant increase (>500 ppm) in CO2 production, reduced carboxyhemoglobin (COHgb) half-life (COHgb t1/2), and increased cerebral O2 delivery and attenuation of CO-induced microglial damage in a preclinical rodent model of CO toxicity.

A modern literature review of carbon monoxide poisoning theories, therapies, and potential targets for therapy advancement.

The first descriptions of carbon monoxide (CO) and its toxic nature appeared in the literature over 100 years ago in separate publications by Drs. Douglas and Haldane. Both men ascribed the deleterious effects of this newly discovered gas to its strong interaction with hemoglobin.

The use of high-dose hydroxocobalamin for vasoplegic syndrome.

We describe a case of hypotension on cardiopulmonary bypass for coronary artery bypass grafting, double valve repairs, and patent foramen ovale closure. The patient experienced vasoplegic syndrome while on cardiopulmonary bypass. He was treated with high-dose hydroxocobalamin (vitamin B12).

The relationship of isotopic bone imaging findings to prognosis in Legg-Perthes disease.

A significant association was observed between the size of the radioactive uptake defect on bone image and the end-result (Mose) in 34 hips of children with early Legg-Perthes disease. A correlation between the size of the bone-image defect and radiographic prognostic criteria, Catterall classification and extent of subchondral fissure was also observed in 27 early Legg-Perthes cases. Bone imaging is recommended for suspected Legg-Perthes patients, not only to establish the diagnosis but to assess the stage of disease and to determine prognosis.