Acute and chronic effects of ammonia burns on the respiratory tract.

Exposure to anhydrous ammonia can result in substantial injury to the respiratory system, eyes, and integument. In this retrospective study, we present the acute and chronic respiratory manifestations in 12 patients exposed to anhydrous ammonia as a result of the same accident. Survivors suffering significant ill effects are separated into two groups according to history and clinical course. One group of patients sustained exposure to high concentrations of ammonia over a short period of time. They manifested upper airway obstruction and required early intubation or tracheostomy. These patients recovered with few pulmonary sequelae and are presently in good pulmonary health. The second group of patients were exposed to lower concentrations of gas over a prolonged period of time and did not manifest upper airway obstruction. In this group of patients, however, significant long-term pulmonary sequelae are manifested.