Sodium azide (NaN3) intoxication, “the man who lived”: potential effective antidote and treatment strategy

Jasper X. Geerdink; Greetje van der Wal; Lutea A.A. de Jong; Erik J.H. Olyslager; Thomas W. van den Goorbergh; Leo A.J. Kluijtmans; Peter E. Spronk

doi:10.1186/s13054-025-05330-w

Sodium azide (NaN₃) intoxication, “the man who lived”: potential effective antidote and treatment strategy

Jasper X. Geerdink^*
, Greetje van der Wal
, Lutea A.A. de Jong
, Erik J.H. Olyslager
, Thomas W. van den Goorbergh
, Leo A.J. Kluijtmans
, Peter E. Spronk

^*Corresponding author for this work

Divison of Internal Medicine and Dermatology

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

This case report describes the successful treatment of a suicide attempt involving the ingestion of a supralethal dose of sodium azide (NaN₃), presenting a prospective novel antidote and therapeutic approach. Treatment encompassed the implementation of high-volume continuous veno-venous hemofiltration (HV-CVVH) alongside the administration of levocarnitine. The latter demonstrated a substantial mitigation of lactate concentration. Comprehensive analyses of serum, ultrafiltrate, and urine revealed the efficacy of HV-CVVH in elimination of NaN₃. Our case report presents a potential therapeutic approach for managing otherwise fatal NaN₃ intoxications.

Original language	English
Article number	103
Journal	Critical Care
Volume	29
Issue number	1
DOIs	https://doi.org/10.1186/s13054-025-05330-w
Publication status	Published - 7 Mar 2025

Keywords

CVVH
High-volume continuous veno-venous hemofiltration
HV-CVVH
Levocarnitine
NaN
Sodium azide

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s13054-025-05330-wFinal published version, 1.1 MBLicence: CC BY-NC-ND

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title = "Sodium azide (NaN3) intoxication, “the man who lived”: potential effective antidote and treatment strategy",

abstract = "This case report describes the successful treatment of a suicide attempt involving the ingestion of a supralethal dose of sodium azide (NaN3), presenting a prospective novel antidote and therapeutic approach. Treatment encompassed the implementation of high-volume continuous veno-venous hemofiltration (HV-CVVH) alongside the administration of levocarnitine. The latter demonstrated a substantial mitigation of lactate concentration. Comprehensive analyses of serum, ultrafiltrate, and urine revealed the efficacy of HV-CVVH in elimination of NaN3. Our case report presents a potential therapeutic approach for managing otherwise fatal NaN3 intoxications.",

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doi = "10.1186/s13054-025-05330-w",

language = "English",

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AU - van der Wal, Greetje

AU - de Jong, Lutea A.A.

AU - Olyslager, Erik J.H.

AU - van den Goorbergh, Thomas W.

AU - Kluijtmans, Leo A.J.

AU - Spronk, Peter E.

N1 - Publisher Copyright: © The Author(s) 2025.

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AB - This case report describes the successful treatment of a suicide attempt involving the ingestion of a supralethal dose of sodium azide (NaN3), presenting a prospective novel antidote and therapeutic approach. Treatment encompassed the implementation of high-volume continuous veno-venous hemofiltration (HV-CVVH) alongside the administration of levocarnitine. The latter demonstrated a substantial mitigation of lactate concentration. Comprehensive analyses of serum, ultrafiltrate, and urine revealed the efficacy of HV-CVVH in elimination of NaN3. Our case report presents a potential therapeutic approach for managing otherwise fatal NaN3 intoxications.

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KW - High-volume continuous veno-venous hemofiltration

KW - HV-CVVH

KW - Levocarnitine

KW - NaN

KW - Sodium azide

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Sodium azide (NaN₃) intoxication, “the man who lived”: potential effective antidote and treatment strategy

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Keywords

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