Medicine of the Future in America

Respiratory Failure and Death Following Acute Inhalation: Pathology (7)

These clinical findings correlated with the finding of fibrosis on histologic sections of the lung. The severity of the adult respiratory distress syndrome following mercury vapor inhalation has been described previously. buy yasmin online
All four patients developed spontaneous tension pneumothorax as premorbid events. Tension pneumothorax has been observed in six of the nine reported deaths attributed to mercury inhalation. (In two patients, no mention was made of clinical course.) Barotrauma from prolonged high-pressure ventilation of noncompliant lungs was most likely responsible for these events.
Dimercaprol (BAL) is a chelating agent that functions by displacing heavy metal ions from sulfhydryl groups. The heavy metal dimercaprol complex is then excreted in the urine. Therapy with dimercaprol was started in all patients six days after exposure. Baseline urine and serum mercury concentrations were obtained in case 1 and case 2 prior to the initiation of therapy. A baseline urine concentration was obtained in case 3. These results and subsequent mercury concentration while receiving dimercaprol are shown in Table 1. Case 4 received dimercaprol but serum and urine levels were not obtained. Baseline serum mercury levels were 16.1 jig/dl in case 1 and 12.7 |ig/ dl in case 2. Baseline urine concentrations were 423 (xg/L in case 1, 138 p-g/L in case 2, and 94 jjlg/L in case 3. After three days of chelation therapy, the concentration of serum mercury in case 1 and case 2 had decreased to 10.1 and 9.8 (xg/dl, respectively.

This entry was posted in Pulmonary function and tagged adult respiratory distress syndrome, arterial blood gases, chelation therapy, chest roentgenograms, lung injury.
Copyright © 2012 Medicine of the Future in America www.perfexis.org