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Authors' reply

BMJ 1996; 312 doi: (Published 20 April 1996) Cite this as: BMJ 1996;312:1039
  1. Frederic J Baud,
  2. Eric Bavoux,
  3. Stephen W Borron,
  4. Jerome Hoffman,
  5. Alain Astier
  1. Professor of critical care medicine Attending physician in critical care medicine Visiting researcher Professor of emergency medicine, UCLA Hopital Fernand Widal, 75475 Paris Cedex 10, France
  2. Chief of service Laboratoire de Toxicologie, Hopital Henri Mondor, Paris, France

    EDITOR,—We agree with T M Cook's analysis of the factors resulting in lactic acidosis in acute cyanide poisoning but not with the conclusion. We would like to focus our reply on the mechanisms of lactic acidosis induced by cyanide in mammals.

    At a cellular level, short term exposure of cultured cells to cyanide rapidly induces a dramatic intracellular acidosis associated with increased lactate concentration. The blockade of cellular respiration through …

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