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P A Templeton - One of the best experts on this subject based on the ideXlab platform.
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Chemical Pneumonitis.
Radiologic clinics of North America, 1992Co-Authors: C S White, P A TempletonAbstract:Many organic and nonorganic agents can cause Chemical Pneumonitis. The more soluble agents tend to involve the upper respiratory tract, whereas less soluble agents reach the distal airways, causing pulmonary edema. The initial chest radiograph can be normal for as long as 48 hours, therefore delayed radiographs are important in significant exposures. The most common radiographic pattern is pulmonary edema, although various radiographic opacities have been reported. Acute complications include secondary pneumonia. Long-term complications include bronchiectasis, bronchiolitis obliterans, and lung destruction.
Rick A Mcpheeters - One of the best experts on this subject based on the ideXlab platform.
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Chemical Pneumonitis from hydrocarbon aspiration.
The western journal of emergency medicine, 2008Co-Authors: Keimanh Pham, James Sverchek, Rick A McpheetersAbstract:A three-year-old female presented to the emergency department (ED) with a chief complaint of choking for 20 minutes after ingestion of an unknown clear liquid; this was followed by one episode of emesis. On arrival she had no respiratory distress, and her symptoms had resolved. Her physical exam and vital signs were unremarkable with a room air oxygen saturation of 99% and a respiratory rate of 28 breaths per minute. The patient’s family brought in the water bottle containing the clear substance, and it was identified as naphtha. An initial chest radiograph showed no infiltrates or consolidations. The patient was given nebulized saline and did not require further therapeutic intervention. A repeat chest radiograph (Figure 1) was done four hours after the first, and it showed left lower lobe and right middle lobe infiltrates, demonstrating significant Pneumonitis. Throughout her stay in the ED, she continued to have no respiratory distress, auscultation of her chest remained clear, and her vital signs normal. Nevertheless, the patient was admitted to pediatrics for observation. Her hospital stay was uneventful and she was discharged home in 24 hours after a final chest radiograph showed no interval changes. Figure 1 Exposure to hydrocarbons comes in many forms, but it causes the most damage with aspiration.1 This damage depends on the viscosity (the resistance to flow, measured in Saybolt seconds universal [SSU]); volatility (the propensity to vaporize); and the Chemical side chains of the hydrocarbon. Lower viscosity, especially less than 60 SSU, and higher volatility are associated with a greater chance of aspiration with resultant pulmonary injury.2 While hydrocarbons have been reported to be toxic to various organ systems, the most frequent adverse effect is aspiration, which can cause a Chemical Pneumonitis from direct injury to the lung parenchyma.3 Other effects of aspiration are pulmonary edema, bronchospasm, and resultant hypoxia. On pathology, there is a necrotizing pneumonia along with direct destruction of capillaries, alveolar septae, and the pulmonary epithelium. The surfactant layer, which is composed of lipids, is made soluble by hydrocarbons, causing further damage. Subsequently, there can be atelectasis, interstitial inflammation, and hyaline membrane formation. Patients with hydrocarbon exposure should be placed on a cardiac monitor with continuous pulse oximetry. A chest radiograph should be taken in patients with significant exposure or if they are symptomatic (tachycardia, tachypnea, hypoxia). If aspiration is severe, patients may need intubation and positive pressure ventilation. With minimal exposure, patients can be discharged after a six-hour period of observation. Pulse oximetry and a chest radiograph may be helpful in reassessing the patient before discharge. Symptomatic patients with more severe exposure should be admitted and observed for a minimum of 24 hours.
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Images in Emergency Medicine: Chemical Pneumonitis from Hydrocarbon Aspiration
Western Journal of Emergency Medicine, 2008Co-Authors: Kiemanh Pham, James Sverchek, Rick A McpheetersAbstract:I mages in E mergency M edicine Images in Emergency Medicine: Chemical Pneumonitis from Hydrocarbon Aspiration Keimanh Pham, MD James Sverchek, MD Rick A. McPheeters, DO Kern Medical Center, Department of Emergency Medicine Supervising Section Editor: Eric R. Snoey, MD Submission history: Submitted December 28, 2007; Revision Received February 28, 2008; Accepted March 13, 2008. Reprints available through open access at www.westjem.org [WestJEM. 2008;9:165.] A three-year-old female presented to the emergency department (ED) with a chief complaint of choking for 20 minutes after ingestion of an unknown clear liquid; this was followed by one episode of emesis. On arrival she had no respiratory distress, and her symptoms had resolved. Her physical exam and vital signs were unremarkable with a room air oxygen saturation of 99% and a respiratory rate of 28 breaths per minute. The patient’s family brought in the water bottle containing the clear substance, and it was identified as naphtha. An initial chest radiograph showed no infiltrates or consolidations. The patient was given nebulized saline and did not require further therapeutic intervention. A repeat chest radiograph (Figure 1) was done four hours after the first, and it showed left lower lobe and right middle lobe infiltrates, demonstrating significant Pneumonitis. Throughout her stay in the ED, she continued to have no respiratory distress, auscultation of her chest remained clear, and her vital signs normal. Nevertheless, the patient was admitted to pediatrics for observation. Her hospital stay was uneventful and she was discharged home in 24 hours after a final chest radiograph showed no interval changes. Exposure to hydrocarbons comes in many forms, but it causes the most damage with aspiration. 1 This damage depends on the viscosity (the resistance to flow, measured in Saybolt seconds universal [SSU]); volatility (the propensity to vaporize); and the Chemical side chains of the hydrocarbon. Lower viscosity, especially less than 60 SSU, and higher volatility are associated with a greater chance of aspiration with resultant pulmonary injury. 2 While hydrocarbons have been reported to be toxic to various organ systems, the most frequent adverse effect is aspiration, which can cause a Chemical Pneumonitis from direct injury to the lung parenchyma. 3 Other effects of aspiration are pulmonary edema, bronchospasm, and resultant hypoxia. On pathology, there is a necrotizing pneumonia along with direct destruction of capillaries, alveolar septae, and the pulmonary epithelium. The surfactant layer, which is composed of lipids, is made soluble by hydrocarbons, causing further damage. Subsequently, there can be atelectasis, interstitial inflammation, and hyaline membrane formation. Patients with hydrocarbon exposure should be placed on a cardiac monitor with continuous pulse oximetry. A chest radiograph should be taken in patients with significant exposure or if they are symptomatic (tachycardia, tachypnea, hypoxia). If Volume IX, no . Figure 1. aspiration is severe, patients may need intubation and positive pressure ventilation. With minimal exposure, patients can be discharged after a six- hour period of observation. Pulse oximetry and a chest radiograph may be helpful in reassessing the patient before discharge. Symptomatic patients with more severe exposure should be admitted and observed for a minimum of 24 hours. Address for Correspondence: Kiemanh Pham, MD, Department of Emergency Medicine, Kern Medical Center, 1830 Flower Street, Bakersfield, CA 93308. Email: kiemanh@gmail.com. REFERENCES 1. Lee DC. Hydrocarbons. Marx JA et al. (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 6, 2006, pp2428-32. 2. Dyer S. Hydrocarbons. Wolfson AB, et al. (eds): Harwood-Nuss’ Clinical Practice of Emergency Medicine, ed 4, 2005, pp1590-93. Wax PM, Beuhler MB. Hydrocarbons and Volatile Substances. Tintinalli JE, et al. (eds): Emergency Medicine: A Comprehensive Study Guide, ed 6, 2004, p1124-30. 3 : August 2008 Western Journal of Emergency Medicine
Manish Kumar - One of the best experts on this subject based on the ideXlab platform.
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Fatal Paint thinner ingestion-A case report
Journal of Indian Academy of Forensic Medicine, 2016Co-Authors: Jitendra Singh Tomar, Pradeep Kr Mishra, Mandar Ramchandra Sane, Divyesh Saxena, Manish KumarAbstract:Household poisons can cause serious damage to the health of children. Turpentine is a volatile hydrocarbon used in polishes, solvents, paints and textile industry. It is capable of causing serious toxicity, whether ingested or inhaled. When hydrocarbons are aspirated into the lung, they cause Chemical Pneumonitis, acute respiratory distress syndrome (ARDS), and rarely pneumatoceles and pneumothorax. We report a case of accidental ingestion of turpentine oil by a 13 year old female child brought to SAMC and PGI, Indore, leading to aspiration Pneumonitis and ultimately causing death after 6 days of hospitalization.
P. Griessel - One of the best experts on this subject based on the ideXlab platform.
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An Oral Sodium Citrate-Citric Acid Nonparticulate Buffer
Drug Investigation, 1993Co-Authors: K. A. Payne, S. Wandrag, P. GriesselAbstract:A new nonparticulate buffering solution of sodium citrate and citric acid was tested for its in vitro acid buffering abilities and its potential for producing a Chemical Pneumonitis when instilled down the endotracheal tube of anaesthetised beagle dogs. 25ml of the agent buffered 165ml of 0.1 N hydrochloric acid pH 1.4 to a pH of 3.05. Ten beagle dogs were anaesthetised and had 0.4 ml/kg of the buffering agent instilled down the endotracheal tubes. Thereafter the dogs recovered and two were sacrificed every 24 hours. Arterial blood samples were taken regularly for blood gas analysis. Moderate transient arterial blood gas changes were observed in the first 6 to 12 hours. Pulmonary macroscopic and microscopic examination demonstrated no signs of a Chemical Pneumonitis. We conclude that this agent is effective in raising the pH of hydrochloric acid and that it lacks the potential for canine pulmonary toxicity.
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An Oral Sodium Citrate-Citric Acid Nonparticulate Buffer
Drug Investigation, 1993Co-Authors: K. A. Payne, S. Wandrag, P. GriesselAbstract:A new nonparticulate buffering solution of sodium citrate and citric acid was tested for its in vitro acid buffering abilities and its potential for producing a Chemical Pneumonitis when instilled down the endotracheal tube of anaesthetised beagle dogs. 25ml of the agent buffered 165ml of 0.1 N hydrochloric acid pH 1.4 to a pH of 3.05. Ten beagle dogs were anaesthetised and had 0.4 ml/kg of the buffering agent instilled down the endotracheal tubes. Thereafter the dogs recovered and two were sacrificed every 24 hours. Arterial blood samples were taken regularly for blood gas analysis. Moderate transient arterial blood gas changes were observed in the first 6 to 12 hours. Pulmonary macroscopic and microscopic examination demonstrated no signs of a Chemical Pneumonitis.
C S White - One of the best experts on this subject based on the ideXlab platform.
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Chemical Pneumonitis.
Radiologic clinics of North America, 1992Co-Authors: C S White, P A TempletonAbstract:Many organic and nonorganic agents can cause Chemical Pneumonitis. The more soluble agents tend to involve the upper respiratory tract, whereas less soluble agents reach the distal airways, causing pulmonary edema. The initial chest radiograph can be normal for as long as 48 hours, therefore delayed radiographs are important in significant exposures. The most common radiographic pattern is pulmonary edema, although various radiographic opacities have been reported. Acute complications include secondary pneumonia. Long-term complications include bronchiectasis, bronchiolitis obliterans, and lung destruction.