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意外光气中毒:一例报告及治疗简述

Accidental Phosgene Poisoning: A Case Report and Short Review of Management.

作者信息

Ty Sri Hari, Sudha Ty Dr Sree, Sasanka Ksbs Krishna, Nageswar Rao Konathala, T Pugazhenthan

机构信息

Critical Care Medicine, Omni Hospital, Hyderabad, IND.

Pharmacology, All India Institute of Medical Sciences, Deoghar, IND.

出版信息

Cureus. 2023 Jul 11;15(7):e41679. doi: 10.7759/cureus.41679. eCollection 2023 Jul.

Abstract

BACKGROUND

Phosgene is a chemical used in the manufacture of plastics and pesticides. Phosgene remains one of the most dangerous of today's high-volume chemicals, as evidenced by the deaths and widespread evacuations caused by its release in industrial accidents. The respiratory system is most severely harmed by exposure to phosgene.

CASE PRESENTATION

A 39-year-old male patient arrived feeling short of breath, nauseous, and tachypnoeic after being exposed to triphosgene gas at work. Upon examination, the patient's oxygen saturation (spo2) was 72% without oxygen, 95% on 15 L of oxygen (o2), hemodynamically unstable, and transferred to the intensive care unit (ICU) for additional care. A ventilator was started in non-invasive mode, and antibiotics were administered based on an initial CT scan of the chest that revealed bilateral fluffy alveolar deposits. The same course of treatment was continued on day two. Chest X-ray shadows improved starting on day three. Saturation is 95% after weaning off Niv support and placing 5 L of o2. He was discharged with oral medications once he was hemodynamically stable.

CONCLUSION

An incidental phosgene poisoning is described in detail here, along with its clinical symptoms and treatment. It is critical to suspect phosgene gas exposure and monitor such patients to save lives.

摘要

背景

光气是一种用于制造塑料和杀虫剂的化学物质。光气仍然是当今大量生产的化学物质中最危险的物质之一,工业事故中其泄漏导致的死亡和大规模疏散就证明了这一点。呼吸系统是接触光气时受损害最严重的部位。

病例介绍

一名39岁男性患者在工作中接触三光气后,出现呼吸急促、恶心和呼吸急促的症状前来就诊。检查发现,患者在未吸氧时血氧饱和度(spo2)为72%,吸入15升氧气(o2)时为95%,血流动力学不稳定,被转至重症监护病房(ICU)接受进一步治疗。以无创模式启动呼吸机,并根据胸部初步CT扫描结果给予抗生素治疗,该扫描显示双侧有模糊的肺泡沉积物。第二天继续相同的治疗方案。从第三天开始,胸部X光阴影有所改善。在撤掉无创通气支持并给予5升氧气后,血氧饱和度为95%。患者血流动力学稳定后口服药物出院。

结论

本文详细描述了一例意外光气中毒病例及其临床症状和治疗方法。怀疑有光气暴露并对这类患者进行监测对于挽救生命至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf47/10413168/2cab12322943/cureus-0015-00000041679-i01.jpg

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