Domej Wolfgang, Mitterhammer Heike, Stauber Rudolf, Kaufmann Peter, Smolle Karl Heinz
Department of Internal Medicine, Medical University of Graz, Austria.
J Med Toxicol. 2007 Dec;3(4):173-7. doi: 10.1007/BF03160935.
Gasoline, ingested intentionally or accidentally, is toxic. The majority of reported cases of gasoline intoxication involve oral ingestion or inhalation. Data are scarce on complications and outcomes following hydrocarbon poisoning by intravenous injection.
Following a suicide attempt by intravenous self-injection of 10 ml of gasoline, a 26-year-old medical student was admitted to the intensive care unit (ICU) with hemoptysis, symptoms of acute respiratory failure, chest pain, and severe abdominal cramps. Gas exchange was severely impaired and a chest x-ray indicated chemical pneumonitis. Initial treatment consisted of mechanical ventilation, supportive hyperventilation, administration of nitrogen oxide (NO), and prednisone. Unfortunately, the patient developed multi-organ dysfunction syndrome (MODS) complicated by life-threatening severe vasoplegia within 24 hours after gasoline injection. High doses of vasopressors along with massive amounts of parenteral fluids were necessary. Despite fluid replacement, renal function worsened and required hemofiltration on 5 sequential days. After 12 days of intensive care management, the patient recovered completely and was discharged to a psychiatric care facility.
Intravenous gasoline injection causes major injury to the lungs, the organ bearing the first capillary bed encountered. Treatment of gasoline poisoning is symptomatic because no specific antidote is available. Early and aggressive supportive care may be conducive to a favorable outcome with minimal residual pulmonary sequelae.
有意或意外摄入汽油均具有毒性。多数已报道的汽油中毒病例涉及经口摄入或吸入。关于静脉注射碳氢化合物中毒后的并发症和转归的数据较少。
一名26岁的医科学生静脉自注10毫升汽油自杀未遂后，因咯血、急性呼吸衰竭症状、胸痛和严重腹痛被收入重症监护病房（ICU）。气体交换严重受损，胸部X光显示化学性肺炎。初始治疗包括机械通气、支持性过度通气、给予一氧化氮（NO）和泼尼松。不幸的是，患者在汽油注射后24小时内出现多器官功能障碍综合征（MODS），并伴有危及生命的严重血管麻痹。需要大剂量血管升压药以及大量胃肠外补液。尽管进行了补液，但肾功能仍恶化，连续5天需要进行血液滤过。经过12天的重症监护治疗，患者完全康复，转至精神科护理机构。
静脉注射汽油会对肺部造成严重损伤，肺部是首个遇到的具有毛细血管床的器官。由于没有特效解毒剂，汽油中毒的治疗以对症治疗为主。早期积极的支持性治疗可能有助于获得良好的转归，使肺部后遗症降至最低。
