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Acute respiratory distress syndrome after zinc chloride inhalation: survival after extracorporeal life support and corticosteroid treatment.

Abstract
No standard protocol exists for the treatment of acute respiratory distress syndrome induced by inhalation of smoke from a smoke bomb. In this case, a 23-year-old man was exposed to smoke from a smoke grenade for approximately 10 to 15 minutes without protective breathing apparatus. Acute respiratory distress syndrome developed subsequently, complicated by bilateral pneumothorax and pneumomediastinum 48 hours after inhalation. Despite mechanical ventilation and bilateral tube thoracostomy, the patient was severely hypoxemic 4 days after hospitalization. His condition improved upon treatment with high-dose corticosteroids, an additional 500-mg dose of methylprednisolone, and the initiation of extracorporeal life support. Arterial oxygenation decreased gradually after abrupt tapering of the corticosteroid dose and discontinuation of the life support. On day 16 of hospitalization, the patient experienced progressive deterioration of arterial oxygenation despite the intensive treatment. The initial treatment regimen (ie, corticosteroids and extracorporeal life support) was resumed, and the patient's arterial oxygenation improved. The patient survived.
AuthorsChih-Feng Chian, Chin-Pyng Wu, Chien-Wen Chen, Wen-Lin Su, Chin-Bin Yeh, Wann-Cherng Perng
JournalAmerican journal of critical care : an official publication, American Association of Critical-Care Nurses (Am J Crit Care) Vol. 19 Issue 1 Pg. 86-90 (Jan 2010) ISSN: 1937-710X [Electronic] United States
PMID19304566 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
  • Chlorides
  • Hypnotics and Sedatives
  • Neuromuscular Blocking Agents
  • Zinc Compounds
  • zinc chloride
Topics
  • Anti-Bacterial Agents (therapeutic use)
  • Chlorides (poisoning)
  • Extracorporeal Membrane Oxygenation
  • Humans
  • Hypnotics and Sedatives (therapeutic use)
  • Male
  • Neuromuscular Blocking Agents (therapeutic use)
  • Respiration, Artificial
  • Respiratory Distress Syndrome (chemically induced, therapy)
  • Smoke Inhalation Injury (chemically induced, therapy)
  • Thoracostomy
  • Young Adult
  • Zinc Compounds (poisoning)

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