For the treatment of phosgene poisoning, glucocorticoids and positive pressure ventilation can be recommended as well as supporting measures such as physical rest, antitussives, buffers, sedatives, antibiotics, antispasmodics and possibly diurectics. Roentgenological evaluation of the lungs is advisable. A therapeutic strategy is presented which is based on the phosgene exposure intensity.
Get full access to this article
View all access options for this article.
References
1.
Longcope, W.T. and Luetscher, J.A., Oxygen in the Treatment of Acute Poisoning by Lung Irritant Gases, in Fasciculus on Chemical Warfare Medicine, Vol. II, p. 590, National Research Council, Committee on Treatment of Gas Casualties, Washington, D.C., 1945.
2.
Handels, J.J.A.M. and VAN WEERDEN, G.J., Ventilator Treatment with PEEP in a Case of Severe Pulmonary Edema due to Phosgene Intoxication, Stoepler Symposium, Utrecht, 1976.
3.
Andrieu, G., Meriel, P., Grezes-Rueff, C., Laueng, L. and Suc, J.M., Efficacité de la respiration controlée dans un cas d'intoxication par le phosgen . Arch Mal. Prof., 20: 778, 1959.
4.
Patt H.M., Haemodynamics in Pulmonary Irritant Poisoning, Amer. J. Physiol ., 147: 329, 1946.
5.
Everett, E.D. and Overholt, E.L., Phosgene Poisoning, J. Amer. Med. Assoc., 205: 243, 1968.
6.
Thoma, R. and Siemon G., Beatmung bei Vergiftungen. Intensivmedizin, 13: 169, 1976.
7.
Maly, U., Experimentelle Untersuchungen zum Einfluss der intermittierenden Uberdruckbeatmung auf das toxische Lungenödem, Inaug. DissWürzburg, 1970.
8.
CHADWICK, F.F., Cited in Ref. 4.
9.
Diller, W.F. and Zante, R., Dosis-Wirkungs-Beziehungen bei Phosgen-Einwirkung auf Mensch und Tier, Zentralblatt f. Arbeitsmedizin, 32: 360, 1982.
10.
Scholmerich, P., Schuster, M.P., Schoenborn, H. and Baman, P.P. (Ed.), InterneIntensivmedizin. 2. Aufl. Thieme, Stuttgart, New York ( 1980).
11.
Falke, K.J., First Experiences with Experimental Extracorporal CO2 Removal in Dogs with Pulmonary Edema Induced by Phosgene Inhalation, Proc. Workshop on Extracorporeal Gas Exchange, Internat. Soc. for Artificial Organs, Paris, 1981.
12.
Daunderer, M. and Weer, N., Erste Hilfe bei Vergiftungen, SpringerBerlin-Heidelberg, 1975 .
Zante, R., Dosis — und Therapieprobleme bei der Phosgenvergiftung, Dissertation, Univ. Duesseldorf, 1980.
15.
Harding, S.M. , Mode of action of glucocorticosteroids, Allergologic, 3: 214, 1980.
16.
Ordway, N.K. , The Pathological Physiology of Phosgene Poisoning: Disturbances in the Acid-Base Equilibrium of the Blood, in Fasciculus on Chemical Warfare Medicine, Vol. II, p. 494, National Research Council, Committee on Treatment of Gas Casualties, Washington, D. C. (1945).
17.
Freeman, S., Grodins, F.S. and Kosman, A.J., Sedation in the Treatment of Phosgene Casualties, in Fasciculus on Chemical Warfare Medicine, Vol. II, p. 510, National Research Council, Committee on Treatment of Gas Casualties, Washington, D.C. (1945).
18.
Freeman, S., Grodins, F.S. and Kosman, A.J., The Use of Atropine and Other Antispasmodic Drugs in the Treatment of Phosgene Casualties, in Fasciculus on Chemical Warfare Medicine , Vol. II, p. 521, National Research Council, Committee on Treatment of Gas Casualties, Washington, D.C. (1945).
19.
Diller, W.F. , Radiologische Untersuchungen zur verbesserten Früdiagnose von industriellen Inhalationsvergiftungen mit verzögertem Wirkungseintritt, Verlag f. Medizin Dr. EwaldFischer, Heidelberg, 1976.
20.
Diller, W.F. , Drope, H. and Reichold, H., Eine Phosgen-Indikator-Plakette fuer den aerztlichen Notfall, VI. Internat. Colloquium fuer die Verhuetung von Arbeitsunfaellen and Berufskrankheiten in der chem. Industrie , Frankfurt , 1979
