Pulmonary barotrauma including orbital emphysema following inhalation of toxic gas

Shulman, David L.; Reshef, D.; Нешер, Ронит; Donchin, Yoel; Cotev, Shamay

doi:10.1007/bf00717999

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…These findings were consistent with some former studies on adults (1,26,29,30). These conditions may be followed by severe cough caused by exposure to toxic materials such as chlorine (31) and nitrogen oxide (32). The mechanism of pneumothorax and pneumomediastinum may be the result of alveolar rupture caused by the direct injury of the alveoli (31).…”

Section: Discussionsupporting

confidence: 91%

Inhalation lung injury induced by smoke bombs in children: CT manifestations, dynamic evolution features and quantitative analysis

Zhang

Zhao

et al. 2018

J. Thorac. Dis

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Background: This retrospective study aimed to investigate the computed tomography (CT) manifestations, short-term dynamic evolution features and quantitative lung CT analysis of inhalation lung injury induced by smoke bomb flare.Methods: Eleven pediatric patients (aged 11 to 13) who inhaled the smoke of smoke bombs underwent several low-dose chest CT scans. The image characteristics and their dynamic changes were observed and quantitative CT values were analyzed. The quantitative CT indicators included lung injury CT score (LICTS), lung fibrosis CT score (LFCTS), mean lung density (MLD), normally aerated volume ratio (NAVR) and reductively aerated volume ratio (RAVR). Box-plot was used to analyze the dynamic changes of each indicator and Spearman statistical method was used to analyze the correlation between any two indicators. Results: (I) In most cases, there were multiple consolidation and massive ground-glass opacities (GGOs) in the two lungs, which aggravated in the early stage and then gradually dissoluted in the later stage. LICTS was positively correlated with MLD (r=0.811, P=0.000), while it was negatively correlated with NAVR (r=−0.712, P=0.000). There existed interstitial fibrosis in the later stage, and LFCTS was positively correlated with RAVR (r=0.382, P=0.028). (II) In one case, the patterns were like layered cake, i.e., consolidation with air bronchus signs in the accumulation area, GGOs in the aforementioned area and normal lung in the top area. The patterns aggravated in the early stage and quickly dissolved in the later stage, and only a few residual fibrotic lesions existed on the final scan. (III) For severe cases, pneumomediastinum and subcutaneous emphysema aggravated in the early stage and then gradually dissolved in the later stage. Conclusions: The chest CT manifestations of inhalation lung injury induced by smoke bombs are predominantly GGOs and consolidation. They aggravate in the early stage and gradual dissolute in the later stage. CT quantitative values can contribute to evaluating the extent of this disease, and NAVR and RAVR can be used to assess pulmonary function.

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Section: Discussionsupporting

confidence: 91%

Inhalation lung injury induced by smoke bombs in children: CT manifestations, dynamic evolution features and quantitative analysis

Zhang

Zhao

et al. 2018

J. Thorac. Dis

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“…Two other cases of pulmonary barotrauma with associated pneumomediastinum have been described. 31 • 32 In both instances, facial subcutaneous air was associated with tense orbital emphysema under enough pressure to cause proptosis. This unusual route of air dissection into the orbit is not yet well defined, but investigators have postulated that air may have initially tracked along vascular sheaths to the base of the skull and then through the inferior orbital fissures into the orbit.…”

Section: Discussionmentioning

confidence: 97%

Orbital Emphysema: Case Reports and Review of the Literature

Zimmer-Galler

Bartley

1994

Mayo Clinic Proceedings

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“…A discrepancy in the progression to ARDS over time or severity among different investigations may be attributed to the amount of smoke inhalation, to the duration of exposure, and to whether exposure occurred in an open or confined space. 19 The mechanism involved in pneumothorax or pneumomediastinum is probably the result of alveolar rupture caused by the direct injury of the alveoli or secondarily by barotrauma from mechanical ventilation. In general, these patients had higher HRCT scan scores, suggesting that they had more severe lung injury soon after inhalation.…”

Section: Discussionmentioning

confidence: 99%