No significant proteinuria, casts, or crystals were otherwise noted in any of the patients. Urine output remained greater than 1 ml/kg/h in all of the patients. buy ventolin inhalers
Gastrointestinal symptoms of nausea, vomiting, or diarrhea were noted in all four patients on presentation. These symptoms resolved quickly without signs of hepatic dysfunction. No hepatic abnormalities were seen at autopsy. We are unsure if these symptoms were related to the inhalation of mercury vapor; however, we believe that their transient nature and the lack of histologic abnormality indicate that they had no effect on hospital course or outcome.
Diffuse pulmonary infiltrates and respiratory failure developed in all four cases. Cases 2, 3, and 4 were intubated and placed on mechanical ventilation within 36 hours after exposure; case 1 was intubated and ventilated five days later. All progressed to the adult respiratory distress syndrome requiring high levels of positive end-expiratory pressure and high oxygen concentrations. Case 1 and case 2 survived the longest and developed extremely noncompliant lung function. Peak airway pressure exceeding 90 cm H20 was required to deliver volumes necessary to maintain oxygenation.