Title: Can Hydroxocobalamin be administered via intraosseous access for acute cyanide toxicity?
題目：羥鈷胺能否通過骨髓內途徑給藥治療急性氰化物中毒？
Author 作者: Hong Kim
翻譯：鄭辛甜 校對：肖鋒

Hydroxocobalamin is an effective cyanide antidote when administered intravenously. Although intraosseous (IO) access is often used in critically ill patients with difficult or delayed IV access, the efficacy of IO administration has not been investigated until recently.
靜脈注射羥鈷胺是一種有效的氰化物解毒方式。盡管骨髓內給藥在靜脈給藥困難或有延誤的危重癥患者中較為常用，但是其有效性直到近期才有研究。
In a recent randomized animal study, acute cyanide toxicity was induced in two groups of swine where 150 mg/kg Hydroxocobalamin was administered via IV vs. IO. The survival rate, reversal of hypotension, and laboratory results were similar between the IV and IO group.
在一項最近的隨機動物實驗中，兩組誘導急性氰化物中毒的豬分別通過靜注或骨髓內給予150 mg/kg的羥鈷胺。兩組的存活率、低血壓逆轉以及實驗室監測指標等差異無統計學意義。
The finding of this study suggest that IO administration of Hydroxocobalamin is as efficacious as IV administration and its administration in acute cyanide toxicity should not be delayed due to lack of IV access when IO access is available.
這些研究提示骨髓內給羥鈷胺和靜注一樣有效，當急性氰化物中毒無法通過靜注給藥但可放置髓內針時，不要延誤治療。

References 參考文獻：
Bebarta VS, Pitotti RL, Bondreau S and Tanen DA. Intraosseus versus intravenous infusion of hydroxocobalamin for the treatment of acute severe cyanide toxicity in a swine model. Academic Emergency Medicine. 2014; 21 (11): 1203-1211.