Pulmonary complications in the course of acute poisoning
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 9
Abstract
Acute poisonings are a common cause of respiratory failure. Respiratory insufficiency in poisoning may be due to causes pulmonary and/or extrapulmonary, depending on the primary or secondary dysfunction of pulmonary compartment and/or mechanical compartment. Respiratory failure in cases of poisoning can be caused by direct toxic effects of poison, may develop secondary to organ damage caused by poison, and can also be a complication of medical procedures performed in poisoned patients. Toxic substances can affect both the pulmonary compartment and mechanically, causing parenchymatous respiratory failure – embolism, manifested by a decrease in oxygenation and/or ventilation failure, disorders resulting from respiratory drive, the strength of respiratory and respiratory mechanics, leading to retention of carbon dioxide system. Substances directly irritating the respiratory tract can include hot air, gases, irritant, toxic hydrocarbons and liquid evaporates easily, which can directly damage the lungs. Paralysis of the respiratory center, or central nervous system depressant effects on the central mechanism promotes ventilation of respiratory impairment. This picture observed in the sleeping drug poisoning, drugs, alcohol, and as end-stage form of any significant toxicity in life. Resulting in dysfunction of motor disorders of the respiratory muscles may be caused by eg organophosphorus compounds, some snake venom, botulinum toxin, tetanus toxin, some fungal toxin, curare. Therapeutic procedure will depend on the rate of exacerbation of respiratory failure and pathomechanism of its formation. Severe respiratory insufficiency is an indication for endotracheal intubation, mechanical ventilation and cross-pharmacological treatment. In extreme situations of impaired gas exchange in the lungs apply highly specialized treatments, such as HBO, or ECMO.
Authors and Affiliations
Iwona Jarocka, Piotr Jakubów, Agata Kulikowska, Magdalena Łukasik-Głębocka, Marzena Wojewódzka-Żelezniakowicz, Agnieszka Borysiewicz, Jerzy Ładny, Sławomir Czaban
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