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VOLUME 9 , ISSUE 4 ( October, 2005 ) > List of Articles

CASE REPORT

Severe lung injury following inhalation of nitric acid fumes

Lalitha V. Pillai, Dhananjay P. Ambike, Satish Pataskar, Sunil Vishwasrao, Saifuddin Husainy, Suprashant D. Kulkarni

Keywords : ARDS, Barotraumas, Delayed pulmonary edema, Nitric acid inhalation, Steroids

Citation Information : Pillai LV, Ambike DP, Pataskar S, Vishwasrao S, Husainy S, Kulkarni SD. Severe lung injury following inhalation of nitric acid fumes. Indian J Crit Care Med 2005; 9 (4):244-247.

DOI: 10.4103/0972-5229.19766

License: CC BY-ND 3.0

Published Online: 00-10-2005

Copyright Statement:  Copyright © 2005; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Objective: We present a rare case of survival following inhalation of nitric acid fumes and its decomposition products, which resulted in severe pulmonary edema and Acute Respiratory Distress Syndrome (ARDS). Successful outcome followed ventilatory support and use of steroids. Design: Case report. Setting: Tertiary-level medical intensive care unit. Patient: A single case of inhalation of nitric oxide fumes. Intervention: Ventilatory support and addition of steroids. Measurement and main results: Improvement and discharge. Conclusion: Inhalation of nitric acid fumes and its decomposition gases such as nitrogen dioxide results in delayed onset of severe pulmonary edema deteriorating into ARDS. Intensive respiratory management, ventilatory support, and steroids can help in survival.


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  1. Meredith S, McDonald JC. Work related -disease in United Kingdom 1989 - 1992: report on the SWORD project. Occup Med 1994;44:183.
  2. Anthony Seaton: Occupational Lung Diseases, In: Anthony Seaton, Douglas Seaton, A. Gordon Leitch (Editors): Crofton and Douglas′s Respiratory Diseases, 5th edition. B Blackwell Science Ltd: 2000. p.1446.
  3. Bur A, Wagner A, Roggla M, Berzlanovic A, Herkner H, Sterz F, et al. Fatal pulmonary edema after nitric acid inhalation. Resuscitation 1997;35:33-6.
  4. Touze MD, Desjars P, Baron D, Tasseau F, Delajartre AY, Nicolas F. Collective acute poisoning by nitrous gases. Toxicol Eur Res 1983;5:220-4.
  5. Lehnert BE, Archuleta DC, ElliS T, Session WS, Lehnert NM, Gurley LR, et al. Lung injury following exposure of rats to relatively high mass concentrations of nitrogen dioxide. Toxicology 1994;89:239-77.
  6. David L. Hinkamp; Properties of inorganic acids in Jeanne Mager Stellman, Michael McCann, Leon Warshaw, Carole Brabant et al (Eds) In: Encyclopedia of occupational Health and Safety, 4th edition. international labor office: Geneva; 1998. p. 104.5-104.7.
  7. Teofilo L, Lee-Chiong Jr: Smoke inhalation injury. Postgrad Med J 1999;105.
  8. Hajela R, Janigan DT, Landrigan PL, Boudreau SF, Sebastian S. Fatal pulmonary edema due to nitric acid fume inhalation in three pulp-mill workers. Chest 1990;97:487-9.
  9. Karlson-Stiber C, Hojer J, Sjoholm A, Bluhm G, Salmonson H. Nitrogen dioxide pneumonitis in ice hockey players. J Int Med 1996;239:451.
  10. Sheperd LG. Confined-space accidents on the farm: the manure pit and the silo. Can J Emerg Med 1999;1:2.
  11. Cioffi WG, deLemos RA, Coalson JJ, Gerstmann DA, Pruitt BA Jr. Decreased pulmonary damage in primates with inhalation injury treated with high frequency ventilation. Ann Surg 1993;218:328-35.
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