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KLOR GAZI İNHALASYONLU OLGULARIMIZ

Year 2011, Volume: 25 Issue: 1, 35 - 39, 01.05.2011

Abstract

Acil servise klor gazı inhalasyonu na maruziyet sonrası gelen hastaların şikayetleri, klinik-laboratuvar bulguları ve tedavileri değerlendirildi. Ekim 2010'da Dörtyol Devlet Hastanesi acil servisine fabrikada klor tankı bakımı sırasında ortama yayılan klor gazına maruz kalan 8 hastanın şikayetleri, fizik muayene bulguları, arter kan gazları, akciğer grafileri ve uygulanan tedaviler prospektif olarak değerlendirildi. Yaş ortalaması 26.5±4.9 olan 6'sı erkek 8 hastanın 5'i gözlem sonrası taburcu edilirken, 3 hasta yoğun bakımda gözleme alınarak takip ve tedavi edildi. Başvuru sırasında tüm olgularda öksürük, 4 olguda nefes darlığı, hırıltı ve göğüs ağrısı, 2 olguda gözde ve boğazda yanma hissi, 1 olguda da başağnsı mevcuttu. Olguların ortalama sistolik arter basıncı değeri 108.3±16.3 mm-Hg, diastolik arter basıncı değeri ise 64.6±8.9 mm-Hg idi. Ortalama nabız 76.5±18.5/dk olarak bulundu. Dakika solunum sayısı: 19±4.2 idi. Arteriyel kan gazı değerleri PH: 7.40, PO2: 85.1 ±22.4, PCO2: 33.1 ±3.3, HCO3: 20.8±2.9, Sat%O2: 95.3±3.7, A-a gradient: 25.7±14.3 idi. Solunum sistemi oskültasyonunda, 4 olguda ronküs-ekspiryumda uzama mevcuttu. Hastaların akciğer grafilerinde patoloji saptanmadı. Hastaların 4'üne oksijen ve steroid, 4'üne oksijen, steroid, bronkodilatatör tedavisi verildi. Klinik takibinde 1 hastada reaktif havayolu disfonksiyonu (RADS) geliştiği saptandı. Klor gazı inhalasyonu sık gözlenmekle birlikte solunum yollarında hafif düzeyde etkilenme yaratacağı gibi, daha şiddetli maruziyetlerde RADS gelişimine de neden olabilir.

References

  • 1. Schwartz DA , Blaski CA. Toxic inhalations. In: FishmanAP, Elias JA, Fishman JA, Grippi MA, Kaiser LR, Senior RM,eds. Fishman’s Pulmonary Diseases and Disorders, 3rd Ed. New York, Mc Graw-Hill, 1998; 925-940.
  • 2. Lemke T, Wang R. Emergency department observation for toxicologic exposures. Emerg Med Clin Nort Am 2001; 19: 155-67.
  • 3. Graham DR. Noxious gases and fumes. In: Baum GL, Crapo JD, Celli BR, Karlinsky JB, eds. Textbook of Pulmonary Disease. eds. 6th Ed. Lippincott-Raven Publishers, Philadelphia 1998; 741-753
  • 4. Blanc PD. Acute pulmonary responses to toxic exposures. In Murray JF, Nadel JA, Mason RJ, et al, eds. Textbook of respiratory medicine. 3rd ed. Philadelphia, WB Saunders, 2000; 1903-1914.
  • 5. Nelson LS. Simple asphyxiants and pulmonary irritants. In: Goldfrank LR, Folomenbaum NE, Lewin NA, Weisman RS, Hawland MA, Hoffman RS, editors. Goldfrank’s toxicologic emergencies. 6 th ed. Stamford Connectcut: Appleton- Lange; 1998. p. 1523-34.
  • 6. Polatl› M. Toksik Gaz ‹nhalasyonu. Solunum 2003; 5(6): 244-56.
  • 7. Bosse GM. Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation. J Toxicol Clin Toxicol 1994; 32: 233-41.
  • 8. Ross JAS, Seaton A, Morgan WKL Toxic gases and fumes. In: Morgan WKL, Seaton A. eds. Occupational Lung Diseases. 3rd Ed. WB Saunders Company, Philadelphia 1995; 568-596.
  • 9. Segal E. Toxicity, Chlorine Gas. e-Medicine Journal (serial online) Web site. Available from: http://www.emedicine.com/emerg/topic851. htm. Accessed December 29, 2005.
  • 10. Traub SJ, Hoffman RS, Nelson LS. Case report and literature review of chlorine gas toxicity. Vet Hum Toxicol 2002; 44: 235-9.
  • 11. Mrvos R, Dean BS, Krenzelok EP. Home exposures to chlorine/chloramine gas: Review of 216 cases. South Med J 1993; 86: 654-7.
  • 12. Vinsel PJ. Treatment of acute chlorine gas inhalation with nebulized sodium bicarbonate. J Emerg Med 1990; 8: 327-9.
  • 13. Avflarl›o¤ullar› L, ‹kizceli ‹, Sözüer M, Akdur O, Yücel M, Durukan P ve ark. Akut Klor Gaz› ‹nhalasyonlar›:Olgu Serisi. Turk J Emerg Med 2006; 6(1): 12-5.
  • 14. Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS): persistent asthma syndrome after high level irritant exposure. Chest 1985; 88: 376-84.
  • 15. Shusterman D. Sequelae of respiratory track exposures to irritant chemicals. PCCU, Lesson 2, Volume 15.
  • 16. Gautrin D, Boulet LP, Boutet M, et al. Is reactive airways dysfunction syndrome a variant of occupational asthma? J Allergy Clin Immunol 1994; 93: 12-22.

OUR CASES WITH CHLORINE GAS INHALATION

Year 2011, Volume: 25 Issue: 1, 35 - 39, 01.05.2011

Abstract

We determined the complaints, clinical and laboratory results and therapy of cases of chlorine gas inhalation in emergency department. 8 Chlorine gas inhalation cases who exposured to chlorine gas in factory tank care, admitted to Dörtyol Goverment Hospital emergency department october 2010 were evaluted prospectively, complaints, phsical examination signs, arterial blood gases, lung-X ray results and treatment modolities were evaluted. Mean age of the cases was 26.5±4.9, 6 of cases were men. 5 cases were discharged after observation. 3 cases were observed and treated in intensity care service. There was coughing in all cases, dsypne wheezing and chest pain in 4 cases, burning sensation in the throat and eye in 2 cases, headache in 1 case. Mean systolic arterial pressure of case was 108.3±16.3 mm-Hg, mean diastolic arterial pressure was ise 64.6±8.9 mm- Hg, mean pulse rate was 76.5±18.5/minutes, minute respiratory rate was 19±4.2, Arterial blood gases results were PH:7,40, PO2: 85.1± 22.4, PCO2: 33.1±3.3, HCO3: 20.8±2.9, Sat%O2: 95.3±3.7, A-a gradient: 25.7±14.3. Ronchus and long expiration time was determined in 4 cases, lung-X ray of case were normal, 4 case were treated by oxygen and steroid, 4 cases were treated by oxygen, steroid and bronchodilatator. RADS was estabilished in 1 case. Chlorine gas inhalation can seen common and may affect the airways mildly or way case more severe clinical outcames as RADS.

References

  • 1. Schwartz DA , Blaski CA. Toxic inhalations. In: FishmanAP, Elias JA, Fishman JA, Grippi MA, Kaiser LR, Senior RM,eds. Fishman’s Pulmonary Diseases and Disorders, 3rd Ed. New York, Mc Graw-Hill, 1998; 925-940.
  • 2. Lemke T, Wang R. Emergency department observation for toxicologic exposures. Emerg Med Clin Nort Am 2001; 19: 155-67.
  • 3. Graham DR. Noxious gases and fumes. In: Baum GL, Crapo JD, Celli BR, Karlinsky JB, eds. Textbook of Pulmonary Disease. eds. 6th Ed. Lippincott-Raven Publishers, Philadelphia 1998; 741-753
  • 4. Blanc PD. Acute pulmonary responses to toxic exposures. In Murray JF, Nadel JA, Mason RJ, et al, eds. Textbook of respiratory medicine. 3rd ed. Philadelphia, WB Saunders, 2000; 1903-1914.
  • 5. Nelson LS. Simple asphyxiants and pulmonary irritants. In: Goldfrank LR, Folomenbaum NE, Lewin NA, Weisman RS, Hawland MA, Hoffman RS, editors. Goldfrank’s toxicologic emergencies. 6 th ed. Stamford Connectcut: Appleton- Lange; 1998. p. 1523-34.
  • 6. Polatl› M. Toksik Gaz ‹nhalasyonu. Solunum 2003; 5(6): 244-56.
  • 7. Bosse GM. Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation. J Toxicol Clin Toxicol 1994; 32: 233-41.
  • 8. Ross JAS, Seaton A, Morgan WKL Toxic gases and fumes. In: Morgan WKL, Seaton A. eds. Occupational Lung Diseases. 3rd Ed. WB Saunders Company, Philadelphia 1995; 568-596.
  • 9. Segal E. Toxicity, Chlorine Gas. e-Medicine Journal (serial online) Web site. Available from: http://www.emedicine.com/emerg/topic851. htm. Accessed December 29, 2005.
  • 10. Traub SJ, Hoffman RS, Nelson LS. Case report and literature review of chlorine gas toxicity. Vet Hum Toxicol 2002; 44: 235-9.
  • 11. Mrvos R, Dean BS, Krenzelok EP. Home exposures to chlorine/chloramine gas: Review of 216 cases. South Med J 1993; 86: 654-7.
  • 12. Vinsel PJ. Treatment of acute chlorine gas inhalation with nebulized sodium bicarbonate. J Emerg Med 1990; 8: 327-9.
  • 13. Avflarl›o¤ullar› L, ‹kizceli ‹, Sözüer M, Akdur O, Yücel M, Durukan P ve ark. Akut Klor Gaz› ‹nhalasyonlar›:Olgu Serisi. Turk J Emerg Med 2006; 6(1): 12-5.
  • 14. Brooks SM, Weiss MA, Bernstein IL. Reactive airways dysfunction syndrome (RADS): persistent asthma syndrome after high level irritant exposure. Chest 1985; 88: 376-84.
  • 15. Shusterman D. Sequelae of respiratory track exposures to irritant chemicals. PCCU, Lesson 2, Volume 15.
  • 16. Gautrin D, Boulet LP, Boutet M, et al. Is reactive airways dysfunction syndrome a variant of occupational asthma? J Allergy Clin Immunol 1994; 93: 12-22.
There are 16 citations in total.

Details

Other ID JA84EH63DS
Journal Section Research Article
Authors

Ardanur Karadal This is me

Levent Özdemır

Burcu Özdemır This is me

Feride Karacaer This is me

Publication Date May 1, 2011
Published in Issue Year 2011 Volume: 25 Issue: 1

Cite

APA Karadal, A., Özdemır, L., Özdemır, B., Karacaer, F. (2011). KLOR GAZI İNHALASYONLU OLGULARIMIZ. İzmir Göğüs Hastanesi Dergisi, 25(1), 35-39.