Baud FJ, et al. - In this retrospective case-control observational study, researchers examined the extent of lactic acidosis in response to cyanide poisoning relative to the secondary response caused by cardiovascular shock. Study participants included patients admitted for suspicion of cyanide poisoning or drug overdose. Using multivariable analysis, confounders causing hyperlactacidemia were adjusted. Significantly greater median blood lactate concentration was detected in the cyanide group vs control group. Hyperlactacidemia was identified as the sole factor which significantly predicted cyanide poisoning at an odds of 73.0 (5.7-936.1), as revealed in multivariate analysis. Furthermore, a significant correlation of blood cyanide level with the increase of blood lactate was observed. Overall, the premise that lactic acidosis primarily results from the direct toxicity of cyanide was supported.