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Asgari A, Parak M, Nourian YH, Ghanei M. Phosgene Toxicity Clinical Manifestations and Treatment: A Systematic Review. CELL JOURNAL 2024; 26:91-97. [PMID: 38459726 PMCID: PMC10924841 DOI: 10.22074/cellj.2024.2011864.1405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 03/10/2024]
Abstract
Exposure to phosgene, a colourless poisonous gas, can lead to various health issues including eye irritation, a dry and burning throat, vomiting, coughing, the production of foamy sputum, difficulty in breathing, and chest pain. This systematic review aims to provide a comprehensive overview of the clinical manifestations and treatment of phosgene toxicity by systematically analyzing available literature. The search was carried out on various scientific online databases to include related studies based on inclusion and exclusion criteria with the use of PRISMA guidelines. The quality of the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Thirteen articles were included in this study after the screening process. Inhalation was found to be the primary health problem of phosgene exposure with respiratory symptoms such as coughing and dyspnea. Chest pain and pulmonary oedema were also observed in some cases. Furthermore, pulmonary crackle was the most common reported physical examination. Beyond respiratory tract health issues, other organs involvements such as cardiac, skin, eye, and renal were also reported in some studies. The symptoms can occur within minutes to hours after exposure, and the severity of symptoms depends on the amount of inhaled phosgene. The findings showed that bronchodilators can alleviate symptoms of bronchoconstriction caused by phosgene. Oxygen therapy is essential for restoring oxygen levels and improving respiratory function in cases of hypoxemia. In severe cases, endotracheal intubation and invasive mechanical ventilation are used for artificial respiration, along with the removal of tracheal secretions and pulmonary oedema fluid through suctioning as crucial components of supportive therapy.
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Affiliation(s)
- Alireza Asgari
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Parak
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Yazdan Hasani Nourian
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mostafa Ghanei
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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2
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Zhu X, Xu M, Sun J, Guo D, Zhang Y, Zhou S, Wang S. Hydroamination and Hydrophosphination of Isocyanates/Isothiocyanates under Catalyst‐Free Conditions. European J Org Chem 2021. [DOI: 10.1002/ejoc.202100932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Xiancui Zhu
- Key Laboratory of Functional Molecular Solids Ministry of Education Anhui Laboratory of Molecule-Based Materials College of Chemistry and Materials Science Anhui Normal University Wuhu Anhui 241002 China
| | - Mengchen Xu
- Key Laboratory of Functional Molecular Solids Ministry of Education Anhui Laboratory of Molecule-Based Materials College of Chemistry and Materials Science Anhui Normal University Wuhu Anhui 241002 China
| | - Jinrong Sun
- Key Laboratory of Functional Molecular Solids Ministry of Education Anhui Laboratory of Molecule-Based Materials College of Chemistry and Materials Science Anhui Normal University Wuhu Anhui 241002 China
| | - Dianjun Guo
- Key Laboratory of Functional Molecular Solids Ministry of Education Anhui Laboratory of Molecule-Based Materials College of Chemistry and Materials Science Anhui Normal University Wuhu Anhui 241002 China
| | - Yiwei Zhang
- Key Laboratory of Functional Molecular Solids Ministry of Education Anhui Laboratory of Molecule-Based Materials College of Chemistry and Materials Science Anhui Normal University Wuhu Anhui 241002 China
| | - Shuangliu Zhou
- Key Laboratory of Functional Molecular Solids Ministry of Education Anhui Laboratory of Molecule-Based Materials College of Chemistry and Materials Science Anhui Normal University Wuhu Anhui 241002 China
| | - Shaowu Wang
- Key Laboratory of Functional Molecular Solids Ministry of Education Anhui Laboratory of Molecule-Based Materials College of Chemistry and Materials Science Anhui Normal University Wuhu Anhui 241002 China
- Anhui Laboratory of Clean Catalytic Engineering Anhui Laboratory of Functional Complexes for Materials Chemistry and Application College of Chemical and Environmental Engineering Anhui Polytechnic University Wuhu Anhui 241002 China
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3
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Xu N, Shao Y, Ye K, Qu Y, Memet O, He D, Shen J. Mesenchymal stem cell-derived exosomes attenuate phosgene-induced acute lung injury in rats. Inhal Toxicol 2019; 31:52-60. [PMID: 31068039 DOI: 10.1080/08958378.2019.1597220] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Ning Xu
- Department of Intensive Care Unit, Center of Emergency & Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Center of Radiation Injury, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yiru Shao
- Department of Intensive Care Unit, Center of Emergency & Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Center of Radiation Injury, Jinshan Hospital, Fudan University, Shanghai, China
| | - Kaili Ye
- Department of Intensive Care Unit, Center of Emergency & Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Center of Radiation Injury, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yubei Qu
- Department of Intensive Care Unit, Center of Emergency & Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Center of Radiation Injury, Jinshan Hospital, Fudan University, Shanghai, China
| | - Obulkasim Memet
- Department of Intensive Care Unit, Center of Emergency & Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Center of Radiation Injury, Jinshan Hospital, Fudan University, Shanghai, China
| | - Daikun He
- Department of Intensive Care Unit, Center of Emergency & Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Center of Radiation Injury, Jinshan Hospital, Fudan University, Shanghai, China
| | - Jie Shen
- Department of Intensive Care Unit, Center of Emergency & Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Research Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Intensive Care Unit, Medical Center of Radiation Injury, Jinshan Hospital, Fudan University, Shanghai, China
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4
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Nicholson-Roberts TC. Phosgene use in World War 1 and early evaluations of pathophysiology. J ROY ARMY MED CORPS 2018; 165:183-187. [PMID: 30355742 DOI: 10.1136/jramc-2018-001072] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 09/25/2018] [Accepted: 09/26/2018] [Indexed: 11/04/2022]
Abstract
World War 1 ended 100 years ago. The aftermath included the consolidation of significant advances in medical care of casualties. Some of these advances were made in the care of chemical casualties, in particular the mechanisms of toxicity and treatment of phosgene exposure. Phosgene, or carbonyl chloride, is an extremely poisonous vapour that was used to devastating effect during World War 1. Observations made of acutely poisoned casualties formed the basis of much research in the early post-World War 1 era. Some extremely elegant experiments, some at the nascent Porton Down research facility, further evaluated the toxin and defences against it. Researchers drew on knowledge that was later forgotten and has since been relearnt later in the 20th century and made many correct assumptions. Their work is the bedrock of our understanding of phosgene toxicity that survives to this day. The horrors of chemical warfare prompted the Geneva Protocol of 1925, prohibiting the use of chemical agents in warfare, and chemical warfare on this scale has not been repeated. The ease with which phosgene can be synthesised requires healthcare providers to be familiar with its effects.
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Affiliation(s)
- T C Nicholson-Roberts
- Southampton Centre for Biomedical Research, University of Southampton, Southampton, UK
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Moladoust R, Esrafili MD, Hosseinian A, Alkorta I, Vessally E. Adsorption sensitivity of pristine and Al- or Si-doped boron nitride nanoflake to COCl2: a DFT study. Mol Phys 2018. [DOI: 10.1080/00268976.2018.1532538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Roghayeh Moladoust
- Department of Chemistry, Faculty of Basic Sciences, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Mehdi D. Esrafili
- Laboratory of Theoretical Chemistry, Department of Chemistry, University of Maragheh, Maragheh, Iran
| | - Akram Hosseinian
- School of Engineering Science, College of Engineering, University of Tehran, Tehran, Iran
| | - Ibon Alkorta
- Instituto de Quimica Medica (CSIC), Juan de la Cierva, Madrid, Spain
| | - Esmail Vessally
- Department of Chemistry, Payame Noor University, Tehran, Iran
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6
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Wagh GD, Pathare SP, Akamanchi KG. Sulfated-Tungstate-Catalyzed Synthesis of Ureas/Thioureas via Transamidation and Synthesis of Forchlorofenuron. ChemistrySelect 2018. [DOI: 10.1002/slct.201800954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ganesh D. Wagh
- Department of Pharmaceutical Sciences and Technology Institute of Chemical Technology Matunga; Mumbai India 400019
| | - Sagar P. Pathare
- Department of Pharmaceutical Sciences and Technology Institute of Chemical Technology Matunga; Mumbai India 400019
| | - Krishnacharya G. Akamanchi
- Department of Pharmaceutical Sciences and Technology Institute of Chemical Technology Matunga; Mumbai India 400019
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Quagliano J, Witkiewicz Z, Sliwka E, Neffe S. Precursors of Nerve Chemical Warfare Agents with Industrial Relevance: Characteristics and Significance for Chemical Security. ChemistrySelect 2018. [DOI: 10.1002/slct.201702763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Javier Quagliano
- Applied Chemistry Department, Argentine Institute for Scientific; Technical Research for the Defense (CITEDEF).; Ave. Juan B. de La Salle 4397 B1603ALO Buenos Aires Argentina
| | - Zygfryd Witkiewicz
- Military Institute of Chemical Technology; S.Kaliskiego 2 00-908 Warszawa 49, Warsaw Poland
| | - Ewa Sliwka
- Faculty of Chemistry; Wroclaw University of Science and Technology; wybrzeże Stanisława Wyspiańskiego 27 50-370 Wrocław Poland
| | - Slawomir Neffe
- Head of the Department of Radiometry and Monitoring of Air Pollution; Military Institute of Chemical Technology; S. Kaliskiego 2 00-908 Warszawa 49, Warsaw Poland
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Shen J, Wang J, Shao YR, He DK, Zhang L, Nadeem L, Xu G. Adenovirus-delivered angiopoietin-1 treatment for phosgene-induced acute lung injury. Inhal Toxicol 2013; 25:272-9. [DOI: 10.3109/08958378.2013.777820] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Shen J, Gan Z, Zhao J, Zhang L, Xu G. Ulinastatin reduces pathogenesis of phosgene-induced acute lung injury in rats. Toxicol Ind Health 2012; 30:785-93. [PMID: 23075575 DOI: 10.1177/0748233712463776] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Phosgene (CG) is an industrial chemical used to make plastics, rubbers, dyestuff, and pesticides. Although the inhalation of CG is relatively uncommon, its accidental exposure can lead to acute lung injury (ALI). Ulinastatin, a urinary trypsin inhibitor, has been emerged to use for the treatment of acute inflammatory state of a number of organs including the lung. In this study, we examined the pathogenic changes in the lungs after the inhalation of CG gas and also examined the effect of ulinastatin treatment in reversing these changes in rats. We found that the rats exposed to CG gas at a dose of 5.0 g/m(3) for 5 min led to ALI after 6 h. The signs of lung injury include pulmonary edema, hemorrhage, and cellular infiltration in pulmonary alveoli. In addition, interleukin-15 (IL-15) and intercellular adhesion molecule-1 (ICAM-1) were significantly increased in CG-inhaled animals. Ulinastatin administration at 1 h postexposure significantly reduced the intensity of all the pathological changes in the lungs of these CG-exposed animals. Ulinastatin at a dose of 400 U/g was shown to decrease the total number of cells in bronchoalveolar lavage fluid and the levels of IL-15 and ICAM-1 in the serum. We also found that the structure of the lung was protected by ulinastatin treatment. Thus, our data suggest that ulinastatin can be used as an effective drug for the treatment of CG-induced ALI. The serum levels of IL-15 and ICAM-1 can be used as the markers of lung injury after exposure to CG and may also serve as useful therapeutic targets at an early stage. The effects of long-term treatment of ulinastatin and the mechanisms by which ulinastatin decreases the infiltration of blood cells and reduces cytokines need further investigation.
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Affiliation(s)
- Jie Shen
- Center of Emergency and Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, People's Republic of China Medical Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Zhengyi Gan
- Center of Emergency and Intensive Care Unit, Jinshan Hospital, Fudan University, Shanghai, People's Republic of China Medical Center of Chemical Injury, Jinshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jie Zhao
- Department of Chemical Defense Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, People's Republic of China
| | - Liming Zhang
- Department of Chemical Defense Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, People's Republic of China
| | - Guoxiong Xu
- Center Laboratory, Jinshan Hospital, Fudan University, Shanghai, People's Republic of China
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Baur X, Bakehe P, Vellguth H. Bronchial asthma and COPD due to irritants in the workplace - an evidence-based approach. J Occup Med Toxicol 2012; 7:19. [PMID: 23013890 PMCID: PMC3508803 DOI: 10.1186/1745-6673-7-19] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 09/12/2012] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED BACKGROUND Respiratory irritants represent a major cause of occupational obstructive airway diseases. We provide an overview of the evidence related to irritative agents causing occupational asthma or occupational COPD. METHODS We searched MEDLINE via PubMed. Reference lists of relevant reviews were also screened. The SIGN grading system was used to rate the quality of each study. The modified RCGP three-star system was used to grade the body of evidence for each irritant agent regarding its causative role in either occupational asthma or occupational COPD. RESULTS A total of 474 relevant papers were identified, covering 188 individual agents, professions or work-sites. The focus of most of the studies and the predominant diagnosis was occupational asthma, whereas occupational COPD arose only incidentally.The highest level assigned using the SIGN grading was 2+ (well-conducted systematic review, cohort or case-control study with a low risk of confounding or bias). According to the modified RCGP three-star grading, the strongest evidence of association with an individual agent, profession or work-site ("**") was found for 17 agents or work-sites, including benzene-1,2,4-tricarboxylicacid-1,2-anhydride, chlorine, platinum salt, isocyanates, cement dust, grain dust, animal farming, environmental tobacco smoke, welding fumes or construction work. Phthalic anhydride, glutaraldehyde, sulphur dioxide, cotton dust, cleaning agents, potrooms, farming (various), foundries were found to be moderately associated with occupational asthma or occupational COPD ("*[+]"). CONCLUSION This study let us assume that irritant-induced occupational asthma and especially occupational COPD are considerably underreported. Defining the evidence of the many additional occupational irritants for causing airway disorders will be the subject of continued studies with implications for diagnostics and preventive measures.
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Affiliation(s)
- Xaver Baur
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
| | - Prudence Bakehe
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
| | - Henning Vellguth
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Seewartenstr. 10, 20459, Hamburg, Germany
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Abstract
We report a case of a worker who developed ALI requiring mechanical ventilatory support after attempting to melt ice condensate by applying the flame of an oxy-acetylene torch to refrigeration coils charged with a halocarbon refrigerant in a closed environment. A discussion of possible etiologies are discussed, including phosgene, carbonyl fluoride, and nitrogen oxides. Primary prevention with adequate respiratory protection is recommended whenever deicing is performed in a closed space environment.
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Affiliation(s)
- Nathanael J McKeown
- Department of Emergency Medicine, Oregon Poison Center & Oregon Health & Science University, Portland, Oregon 97239, USA.
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12
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Grainge C, Smith A, Jugg B, Fairhall S, Mann T, Perrott R, Jenner J, Millar T, Rice P. Furosemide in the Treatment of Phosgene Induced Acute Lung Injury. J ROY ARMY MED CORPS 2010. [DOI: 10.1136/jramc-156-04-08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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13
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Grainge C, Jugg BJ, Smith AJ, Brown RFR, Jenner J, Parkhouse D, Rice P. Delayed low-dose supplemental oxygen improves survival following phosgene-induced acute lung injury. Inhal Toxicol 2010; 22:552-60. [DOI: 10.3109/08958370903571831] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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14
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Warden CR. Respiratory agents: irritant gases, riot control agents, incapacitants, and caustics. Crit Care Clin 2005; 21:719-37, vi. [PMID: 16168311 DOI: 10.1016/j.ccc.2005.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There are many chemical respiratory agents suitable for use by terrorists. They are the oldest chemical agents used and have caused the most casualties throughout the 20th century. Many are available in large quantities for industrial use and are susceptible to potential sabotage. This paper will concentrate on respiratory agents that are readily available and have the potential to cause a large number of casualties and panic. These agents have a lower rate of lethality when compared to other chemical agents but could produce many casualties that may overwhelm the emergency medical system.
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Affiliation(s)
- Craig R Warden
- Oregon Health & Science University, UHN52, Department of Emergency Medicine, 3181 SW Sam Jackson Park Road, Portland, OR 97201, USA.
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Brown RFR, Jugg BJA, Harban FMJ, Ashley Z, Kenward CE, Platt J, Hill A, Rice P, Watkins PE. Pathophysiological responses following phosgene exposure in the anaesthetized pig. J Appl Toxicol 2002; 22:263-9. [PMID: 12210544 DOI: 10.1002/jat.857] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This study aimed to develop a reproducible model of phosgene-induced lung injury in the pig to facilitate the future development of therapeutic strategies. Ten female young adult large white pigs were used. Following induction of anaesthesia using a halothane/oxygen/nitrous oxide mixture, arterial and venous catheters were inserted together with a pulmonary artery thermodilution catheter, and a suprapubic urinary catheter by laparotomy. Anaesthesia was maintained throughout the experiment by intravenous infusion of ketamine, midazolam and alfentanil. On completion of surgery the animals were allowed to equilibrate for 1 h and then were divided into two groups. Group 1 (n = 5) was exposed to phosgene for 10 min (mean Ct = 2443 +/- 35 mg min m(-3)) while spontaneously breathing, whereas control animals (Group 2 n = 5) were exposed to air. At 30 min post-exposure, anaesthesia was deepened in order to allow the initiation of intermittent positive pressure ventilation and the animals were monitored for up to 24 h. Cardiovascular and respiratory parameters were monitored every 30 min and blood samples were taken for arterial and mixed venous blood gas analysis and clinical chemistry. A detailed post-mortem and histopathology was carried out on all animals following death or euthanasia at the end of the 24-h monitoring period. Control animals (Group 2) all survived until the end of the 24-h monitoring period with normal pathophysiological parameters. Histopathology showed only minimal passive congestion of the lung. Following exposure to phosgene (Group 1) there was one survivor to 24 h, with the remainder dying between 16.5 and 23 h (mean = 20 h). Histopathology from these animals showed areas of widespread pulmonary oedema, petechial haemorrhage and bronchial epithelial necrosis. There was also a significant increase in lung wet weight/body weight ratio (P < 0.001). During and immediately following exposure, a transient decrease in oxygen saturation and stroke volume index was observed. From 6 h there were significant decreases in arterial pH (P < 0.01), P(a)O(2) (P < 0.01) and lung compliance (P < 0.01), whereas oxygen delivery and consumption was reduced from 15 h onwards in phosgene-exposed animals. Mean pulmonary artery pressure of phosgene-exposed animals was increased from 15 h post-exposure, with periods of increased pulmonary vascular resistance index being recorded from 9 h onwards. We have developed a reproducible model of phosgene-induced lung injury in the anaesthetized pig. We have followed changes in cardiovascular and pulmonary dynamics for up to 24 h after exposure in order to demonstrate evidence of primary acute lung injury from 16 h post-exposure. Histopathology showed evidence of widespread damage to the lung and there was also a significant increase in lung wet weight/body weight ratio (P < 0.001).
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Affiliation(s)
- R F R Brown
- Biomedical Sciences Department, Defence Science and Technology Laboratory, Chemical and Biological Sciences, Porton Down, Salisbury SP4 0JQ, UK
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