Abstract
AimHydrogen sulphide (H2S) intoxication in man is frequently associated with a fatal outcome. In small animal models hydrogen sulphide has demonstrated profound protection against hypoxia. No reports that focus on a potential protective effect in humans have been published. MethodsThe frequency and outcome of a large cohort of hydrogen sulphide intoxications is described. ResultsFrom 1980 until 2013, 35 accidents totalling 56 victims occurred of whom at least 24 (43%) survived. Of the 8 patients with documented cardiopulmonary resuscitation on the scene, 6 (75%) survived. In some of these cases with good outcome the exposure time to very high hydrogen sulphide levels before extraction and resuscitation was more than 45min. ConclusionManure related hydrogen sulphide intoxication is associated with a high mortality, although in some cases, recovery appears to be far more favourable than the initial presentation would suggest. Possibly protection from hypoxic injury due to induction of a suspended animation-like state by hydrogen sulphide may be responsible.
Highlights
When Heracles was assigned to clean the Augean stables he managed the job by rerouting two rivers through the stables that flushed out the cow dung
This was a wise thing to do as it saved him considerable work, and in addition prevented him from inhaling manure gas
We examined the results of this public report in detail and identified patients who had cardiopulmonary resuscitation at the scene to compare the outcome of these patients with out-of-hospital cardiac arrest in general
Summary
When Heracles was assigned to clean the Augean stables he managed the job by rerouting two rivers through the stables that flushed out the cow dung. This was a wise thing to do as it saved him considerable work, and in addition prevented him from inhaling manure gas. Hydrogen sulphide (H2S) is a highly toxic gas that can be rapidly fatal for workers that are exposed in installations such. Many case reports and cohort studies bear witness to the lethal effects of exposure to hydrogen sulphide with often multiple fatalities.[1]
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