A 31-year-old woman is rescued from a house fire. She presents with BP 88/52, HR 112, RR 22, SpO2 98% on supplemental oxygen, and altered mental status. Laboratory testing reveals serum lactate 8.2 mmol/L despite adequate oxygen delivery and normal hemoglobin saturation. Arterial blood gas shows metabolic acidosis. She denies chest pain. Which antidote most directly binds cyanide to form cyanocobalamin?
- A)Flumazenil
- B)HydroxocobalaminGABARITO
- C)Sodium bicarbonate
- D)Pralidoxime
- E)Deferoxamine
Explicação
Cyanide inhibits cytochrome oxidase in the electron transport chain, causing histotoxic hypoxia and severe lactic acidosis. Hydroxocobalamin binds cyanide to form cyanocobalamin, which can then be excreted. Ver explicação completa e trilha adaptativa →