M. Bauer, P. Radermacher, M. Wepler
2019
Citations
0
Influential Citations
3
Citations
Journal
Annual Update in Intensive Care and Emergency Medicine 2019
Abstract
Sodium thiosulfate (Na2S2O3) is a cation-chelating agent and has various application areas in the chemical industry, e.g., in processes of water purification and in the mining industry. In medicine, sodium thiosulfate is a recognized drug since its identification as an antidote for minimum lethal doses of sodium cyanide back in 1933 [1]. Sodium thiosulfate acts as a sulfur donor for sulfurtransferase to convert cyanide to thiocyanide, which is less toxic and can be eliminated via the urine. Therefore, sodium thiosulfate still serves as a treatment for cyanide poisoning worldwide. Besides its use as a treatment for cyanide poising, sodium thiosulfate is also used as an antioxidant, has chelating properties, and induces release of hydrogen sulfide (H2S) and nitric oxide (NO) in vivo, causing vasodilation (Fig. 14.1) [2]. Due to these chemical properties, sodium thiosulfate is an accepted drug for the treatment of chronic renal failure-induced calciphylaxis [3] and cisplatin poising [4], and has recently been recognized to lower the incidence of cisplatin-induced hearing loss among children with hepatoblastoma [5]. Furthermore, the anti-oxidant and the H2S-releasing properties of sodium thiosulfate have prompted a study in patients with acute coronary syndrome (ClinicalTrials.gov Identifiers NCT03017963 and NCT02899364).