Fatal Pulmonary Edema After Acute Occupational Exposure to Nitric Acid

Murphy, Christine; Akbarnia, Halleh; Rose, S. Rutherfoord

doi:10.1016/j.jemermed.2008.03.011

Cited by 25 publications

(28 citation statements)

References 7 publications

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“…Table 2 summarizes case reports of pulmonary injury due to nitrogen oxides [1], [3], [9], [11], [13], [14], [15]. In most cases, steroid therapy was induced, and in our case, the lung injury did not resolve until corticosteroids were administered.…”

Section: Discussionmentioning

confidence: 78%

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Successful treatment of pulmonary injury after nitrogen oxide exposure with corticosteroid therapy: A case report and review of the literature

Kido

Mitani

Isago

et al. 2017

Respiratory Medicine Case Reports

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Nitrogen oxides are representative chemicals of occupational and environmental exposure, which can lead to fatal pulmonary injury. These oxides are also known to cause delayed occurrence of bronchiolitis obliterans (BO). Herein, we report a case of nitrogen oxide-induced lung injury. A 50-year-old man developed pulmonary edema after nitric acid exposure. Hypoxemia and respiratory failure were immediately improved after introduction of corticosteroid pulse therapy with supplemental oxygen. This was followed by administration of oral prednisolone, and delayed BO did not develop. This case supports the therapeutic efficacy of corticosteroids against pulmonary injury and late-onset BO after nitrogen oxide exposure.Key clinical messageProlonged oral prednisolone might be a potential therapy to prevent delayed onset of bronchiolitis obliterans after nitric acid exposure.

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Section: Discussionmentioning

confidence: 78%

“…Nitrogen oxides, which are chemically converted from nitric acid, are occupational and environmental causes of toxic gas-related bronchiolar disorders [1]. Such disorders have been reported in industrial manufacturing, metal etching, and feed soils.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of pulmonary injury after nitrogen oxide exposure with corticosteroid therapy: A case report and review of the literature

Kido

Mitani

Isago

et al. 2017

Respiratory Medicine Case Reports

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show abstract

“…HNO 3 fumes may also contain a mixture of HNO 3 with various oxides of nitrogen (NO, NO 2 ) [1]. Accidental spillage of HNO3 generates nitrogen oxides that cause chemical pneumonitis when inhaled.…”

mentioning

confidence: 99%

Anesthetic management of a patient with nitric acid inhalation injury for extracorporeal membrane oxygenation

Lee

Kim

et al. 2012

Korean J Anesthesiol

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“…Another case involved a 25-year-old male worker who survived pulmonary edema that developed eight hours after exposure and was discharged on 11 th day of his admission [3]. Murphy et al [4] also reported a fatal pulmonary edema and circulatory collapse 53 hours after occupational exposure to nitric acid. Treatment is largely supportive and the use of nitric oxide (NO) has not been investigated in nitric acid induced pulmonary edema.…”

mentioning

confidence: 99%

“…Treatment is largely supportive and the use of nitric oxide (NO) has not been investigated in nitric acid induced pulmonary edema. Inhalation therapy with NO was previously tried in two cases but the patients were lost due to refractory respiratory failure [4,5].…”

mentioning

confidence: 99%