Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Critical Care
Published in: Critical Care 1/2019

Open Access 01-12-2019 | Acute Kidney Injury | Research

Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study

Authors: François Dépret, Clément Hoffmann, Laura Daoud, Camille Thieffry, Laure Monplaisir, Jules Creveaux, Djillali Annane, Erika Parmentier, Daniel Mathieu, Sandrine Wiramus, Dominique Demeure DIt Latte, Aubin Kpodji, Julien Textoris, Florian Robin, Kada Klouche, Emmanuel Pontis, Guillaume Schnell, François Barbier, Jean-Michel Constantin, Thomas Clavier, Damien du Cheyron, Nicolas Terzi, Bertrand Sauneuf, Emmanuel Guerot, Thomas Lafon, Alexandre Herbland, Bruno Megarbane, Thomas Leclerc, Vincent Mallet, Romain Pirracchio, Matthieu Legrand

Published in: Critical Care | Issue 1/2019

Login to get access

Abstract

Background

The use of hydroxocobalamin has long been advocated for treating suspected cyanide poisoning after smoke inhalation. Intravenous hydroxocobalamin has however been shown to cause oxalate nephropathy in a single-center study. The impact of hydroxocobalamin on the risk of acute kidney injury (AKI) and survival after smoke inhalation in a multicenter setting remains unexplored.

Methods

We conducted a multicenter retrospective study in 21 intensive care units (ICUs) in France. We included patients admitted to an ICU for smoke inhalation between January 2011 and December 2017. We excluded patients discharged at home alive within 24 h of admission. We assessed the risk of AKI (primary endpoint), severe AKI, major adverse kidney (MAKE) events, and survival (secondary endpoints) after administration of hydroxocobalamin using logistic regression models.

Results

Among 854 patients screened, 739 patients were included. Three hundred six and 386 (55.2%) patients received hydroxocobalamin. Mortality in ICU was 32.9% (n = 243). Two hundred eighty-eight (39%) patients developed AKI, including 186 (25.2%) who developed severe AKI during the first week. Patients who received hydroxocobalamin were more severe and had higher mortality (38.1% vs 27.2%, p = 0.0022). The adjusted odds ratio (95% confidence interval) of AKI after intravenous hydroxocobalamin was 1.597 (1.055, 2.419) and 1.772 (1.137, 2.762) for severe AKI; intravenous hydroxocobalamin was not associated with survival or MAKE with an adjusted odds ratio (95% confidence interval) of 1.114 (0.691, 1.797) and 0.784 (0.456, 1.349) respectively.

Conclusion

Hydroxocobalamin was associated with an increased risk of AKI and severe AKI but was not associated with survival after smoke inhalation.

Trial registration

Appendix
Available only for authorised users
Literature
1.
Lawson-Smith P, Jansen EC, Hyldegaard O. Cyanide intoxication as part of smoke inhalation - a review on diagnosis and treatment from the emergency perspective. Scand J Trauma Resusc Emerg Med. 2011;19:14.CrossRef
2.
Petrikovics I, Budai M, Kovacs K, Thompson DE. Past, present and future of cyanide antagonism research: from the early remedies to the current therapies. World J Methodol. 2015;5:88–100.CrossRef
3.
Anseeuw K, Delvau N, Burillo-Putze G, De Iaco F, Geldner G, Holmström P, et al. Cyanide poisoning by fire smoke inhalation: a European expert consensus. Eur J Emerg Med. 2013;20:2–9.CrossRef
4.
Legrand M, Michel T, Daudon M, Benyamina M, Ferry A, Soussi S, et al. Risk of oxalate nephropathy with the use of cyanide antidote hydroxocobalamin in critically ill burn patients. Intensive Care Med. 2016;42:1080–1.CrossRef
5.
Legrand M, Mallet V. Intravenous hydroxocobalamin and crystal nephropathy. Nat Rev Nephrol. 2017;13:593.CrossRef
6.
Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Work group membership. Kidney Int. 2012;2:1.CrossRef
7.
Monafo W. Initial management of burns. N Engl J Med. 1996;335(21):1581–6.CrossRef
8.
Chou SH, Lin S-D, Chuang H-Y, Cheng Y-J, Kao EL, Huang M-F. Fiber-optic bronchoscopic classification of inhalation injury: prediction of acute lung injury. Surg Endosc. 2004;18:1377–9.CrossRef
9.
Bartlett JW, Seaman SR, White IR, Carpenter JR, for the Alzheimer’s Disease Neuroimaging Initiative*. Multiple imputation of covariates by fully conditional specification: accommodating the substantive model. Stat Methods Med Res. 2015;24:462–87.CrossRef
10.
Baud FJ, Borron SW, Mégarbane B, Trout H, Lapostolle F, Vicaut E, et al. Value of lactic acidosis in the assessment of the severity of acute cyanide poisoning. Crit Care Med. 2002;30:2044–50.CrossRef
11.
Baud FJ, Haidar MK, Jouffroy R, Raphalen J-H, Lamhaut L, Carli P. Determinants of lactic acidosis in acute cyanide poisonings. Crit Care Med. 2018;46:e523–9.CrossRef
12.
Kadri SS, Miller AC, Hohmann S, Bonne S, Nielsen C, Wells C, et al. Risk factors for in-hospital mortality in smoke inhalation-associated acute lung injury: data from 68 United States hospitals. Chest. 2016;150:1260–8.CrossRef
13.
Borron SW, Baud FJ, Barriot P, Imbert M, Bismuth C. Prospective study of hydroxocobalamin for acute cyanide poisoning in smoke inhalation. Ann Emerg Med. 2007;49:794–801.e2.CrossRef
14.
Fortin J-L, Giocanti J-P, Ruttimann M, Kowalski J-J. Prehospital administration of hydroxocobalamin for smoke inhalation-associated cyanide poisoning: 8 years of experience in the Paris fire brigade. Clin Toxicol. 2006;44:37–44.CrossRef
15.
Nguyen L, Afshari A, Kahn SA, McGrane S, Summitt B. Utility and outcomes of hydroxocobalamin use in smoke inhalation patients. Burns. 2017;43(1):107–13.CrossRef
16.
17.
Legrand M, Mik EG, Johannes T, Payen D, Ince C. Renal hypoxia and dysoxia after reperfusion of the ischemic kidney. Mol Med Camb Mass. 2008;14:502–16.PubMed
18.
Legrand M, Almac E, Mik EG, Johannes T, Kandil A, Bezemer R, et al. L-NIL prevents renal microvascular hypoxia and increase of renal oxygen consumption after ischemia-reperfusion in rats. Am J Physiol Renal Physiol. 2009;296:F1109–17.CrossRef
19.
Soussi S, Dépret F, Benyamina M, Legrand M. Early hemodynamic management of critically ill burn patients. Anesthesiology. 2018;129:583–9.CrossRef
Metadata
Title
Association between hydroxocobalamin administration and acute kidney injury after smoke inhalation: a multicenter retrospective study
Authors
François Dépret
Clément Hoffmann
Laura Daoud
Camille Thieffry
Laure Monplaisir
Jules Creveaux
Djillali Annane
Erika Parmentier
Daniel Mathieu
Sandrine Wiramus
Dominique Demeure DIt Latte
Aubin Kpodji
Julien Textoris
Florian Robin
Kada Klouche
Emmanuel Pontis
Guillaume Schnell
François Barbier
Jean-Michel Constantin
Thomas Clavier
Damien du Cheyron
Nicolas Terzi
Bertrand Sauneuf
Emmanuel Guerot
Thomas Lafon
Alexandre Herbland
Bruno Megarbane
Thomas Leclerc
Vincent Mallet
Romain Pirracchio
Matthieu Legrand
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2019
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-019-2706-0

Other articles of this Issue 1/2019

Critical Care 1/2019 Go to the issue

Research

A meta-analysis of the resuscitative effects of mechanical and manual chest compression in out-of-hospital cardiac arrest patients

Research

Thromboxane–prostaglandin receptor antagonist, terutroban, prevents neurovascular events after subarachnoid haemorrhage: a nanoSPECT study in rats

Research

Dysbiosis of the intestinal microbiota in neurocritically ill patients and the risk for death

Letter

SEA-mulation: training for technical treatment related to emergency situations in maritime environment

Research Letter

Improving identification of pulmonary embolism-related out-of-hospital cardiac arrest to optimize thrombolytic therapy during resuscitation

Research

An overview of positive cultures and clinical outcomes in septic patients: a sub-analysis of the Prehospital Antibiotics Against Sepsis (PHANTASi) trial