Chemical liquid inhalation

Introduction to chemical liquid inhalation Clinically aspirating chemical fluids mainly include kerosene, gasoline, diesel, mineral oil, animal oil, vegetable oil, furniture polish and other petroleum solvents. The clinical characteristics of aspiration of various chemical liquids are based on the stability of their chemical properties, inhalation. The amount and the frequency of inhalation and whether or not to inhale other substances at the same time are different, and most lack specific treatment. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: anaerobic infection

Chemical liquid inhalation cause

(1) Causes of the disease

1. Common substances that inhale chemical liquids such as diesel, gasoline, mineral oil, animal oil and vegetable oils.

2. Another cause is acupuncture protective reflexes and glottic closure disorders that are aspiration.

(two) pathogenesis

Normal people have a synergistic effect on the protective reflex and swallowing of the throat. Generally, food and foreign matter are not easy to enter the lower respiratory tract. Even if a small amount of liquid is sucked, it can be discharged by coughing. In the case of unconsciousness such as general anesthesia, cerebrovascular accident, seizure, alcoholism, overdose or sedative, the defense function is weakened or disappeared, foreign body can be inhaled into the trachea; esophageal lesions such as esophageal achalasia, upper esophageal cancer Swelling, Zenker's esophageal diverticulum, esophageal pharynx can not all enter the stomach, reverse into the trachea; tracheal esophageal fistula caused by various reasons, food can enter the trachea directly through the esophagus; iatrogenic factors such as gastric tube stimulation of the pharynx caused by vomiting; trachea Intubation or tracheotomy affects laryngeal function, inhibiting normal pharyngeal movements and inhaling vomit into the airway. Older people with poor reactivity are more likely to develop aspiration pneumonia.

Acute gastric inflammatory response is caused by gastric acid inhalation after gastric inhalation, and its severity is related to the concentration of hydrochloric acid in the gastric juice, the amount of inhalation, and the distribution in the lung. When the pH of inhaled gastric acid is 2.5, the inhalation of 25 ml can cause serious lung tissue damage. It has been confirmed in animal experiments that inhalation of a liquid having a pH < 1.5 can cause death in 3 ml/kg body weight. The wider the distribution of the inhalation fluid, the more severe the damage.

Chemical liquid inhalation prevention

Take immediate action to stop the inhalation of chemical liquids, such as leaving the site, replacing dirt, and cleaning the skin and mouth.

Chemical fluid inhalation complications Complications anaerobic infection

May be associated with anaerobic infections such as aspiration pneumonia.

Inhalation of vomit can cause wheezing and coughing in the throat and bronchial irritation. Inhalation pneumonia caused by esophagus and bronchospasm. After eating, there is a coughing cough with shortness of breath. If you are unconscious, there is no obvious symptom after inhalation. However, after 1~2 hours, you may have difficulty breathing, cyanosis, and often cough. Serous foamy sputum, can carry blood. Both lungs can smell wet snoring and wheezing, severe hypoxemia, acute respiratory distress syndrome (ARDS), and can be associated with carbon dioxide retention and metabolic acidosis.

Symptoms of chemical liquid inhalation Common symptoms Dysphagia, nausea, sore throat, shortness of breath, hoarseness, stuffy nose, chest tightness, cough, chest pain, chills

Early manifestations of throat burning, sore throat, nasal congestion, hoarseness, etc., but inhaled different chemical fluids, clinical performance is different.

1. The main components of diesel diesel are alkane and aromatic hydrocarbons, all of which are high-boiling substances, so the chance of damage caused by steam is less. Most of the diesel inhaled respiratory tract is a person engaged in driving profession, which can be expressed as fever, chills, cough, and sputum. Blood, severe chest pain, with chest tightness, may have nausea, vomiting, abdominal pain, melena and other gastrointestinal symptoms, lesions more common in the right lung, can smell dry and wet voice.

2. The main components of gasoline gasoline are C4C12 aliphatic hydrocarbons and cyclic hydrocarbons, and contain a small amount of aromatic hydrocarbons and sulfides. They are volatile, flammable liquids, insoluble in water, soluble in fats and organic solvents, and high inhalation. The concentration of gasoline vapor can cause acute poisoning, mainly manifested as central nervous system anesthesia.

Gasoline aspiration pneumonia, more common in car drivers, clinical performance and the amount of gasoline inhaled, can immediately appear hemoptysis, cough, chest pain, chest tightness, shortness of breath, fever and other symptoms, exhaled gasoline smell, lung auscultation has a rough breath sound, Dry sound or wet squeaking, inhaled gasoline can quickly pass through the blood-cerebrospinal fluid barrier, damage brain tissue, can directly cause kidney damage, produce hematuria, gasoline inhaled mainly by the prototype exhaled from the lungs, the rest is discharged with the urine.

3. Mineral oil Mineral oil is often used as a lubricant. Aspiration is more common in patients with constipation and dysphagia. The contrast agent also contains mineral oil. After aspiration, it mainly manifests as exogenous lipid pneumonia. Lipid pneumonia is rare, and the chemical properties of mineral oil are stable, so most of them have no obvious cough after aspiration.

Most patients are asymptomatic, only X-ray chest radiographs have abnormal performance, can complain of cough and chest pain, long-term repeated inhalation of lipids can produce diffuse fibrosis, eventually leading to pulmonary heart disease, sputum or bronchoalveolar lavage fluid macrophages contain Fat droplets suggest the possibility of the disease, and a bronchoscopy lung biopsy usually determines the diagnosis.

4. Animal oil and vegetable oil inhaled milk, dairy products and cod liver oil contain animal oil. The aspiration is mainly caused by infants and children when feeding. Animal fat can be hydrated into fatty acid by lung esterase, causing acute hemorrhagic pneumonia.

Chemical liquid inhalation inspection

Acute blood: white blood cells rise (3 ~ 4) × 109 / L, more than 90% of neutrophils.

Ordinary fluoroscopy checks the chest X-ray, which increases the density of the large intensities and blurs the infiltrated shadows. The boundary is unclear.

Chemical liquid inhalation diagnosis

diagnosis

Vegetable oil aspiration often occurs when eating or vomiting, causing varying degrees of tissue damage, lung performance can be very mild or similar to the clinical manifestations of inhaled animal oil, chest radiographs vary, including single-fat lipid granuloma, tumor-like Large consolidation, segmental or leaf pneumonia, diffuse alveolar or interstitial infiltration, some vegetable oils have no obvious reaction in the lungs, can exist in the alveolar cavity for a long time without fibrosis or obvious inflammatory reaction; while other vegetable oils can Causes a tissue reaction similar to animal oil.

1. The patient has a history of accidental inhalation.

2. According to the clinical manifestations, common shortness of breath, chest tightness, wheezing and chest pain, etc., early signs are not obvious, due to tracheal sputum, rapid breathing, cyanosis of the lips, lung sounds can be diagnosed.

Differential diagnosis

It is difficult to distinguish from bacterial pneumonia in the early stage.

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