Rating revision: Did I say 3-1/2 skulls? Make that 2.

March 31, 2010, 6:03 pm


Hydroxocobalamin and Sodium Thiosulfate Versus Sodium Nitrite and Sodium Thiosulfate in the Treatment of Acute Cyanide Toxicity in a Swine (Sus Scrofa) Model.  Bebarta VS et al.  Ann Emerg Med April 2010;55:345-351.

When this article was posted online back in December, I reviewed it and gave it three-and-a-half skulls.  Now that it is available in print, I’ve looked at it again and find that on reconsideration I grossly over-rated it.

I stand by my previous comments, but now find it even odder that the authors claim that in their swine model there was no difference between hydroxocobalamin+thiosulfate and nitrite+thiosulfate in mortality, despite the fact that twice as many animals in the nitrite group died during antidote infusion.  This is actually interesting information, but calls out for explanation.  The authors do not discuss this it all, and it is not clear from the paper if any of the remaining animals died.  I’m surprised the editors let this stand.

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