HYDROCARBON TOXICITY
 
PEDBASE.org - The Pediatric Database - Detailed information of HYDROCARBON TOXICITY

 

HYDROCARBON TOXICITY

 

DEFINITION:

Toxic ingestion of either petroleum-distillate hydrocarbons or nonpetroleum-distillate hydrocarbons producing systemic and/or local effects.

EPIDEMIOLOGY:

  • incidence: ?
  • age of onset:
    • any
  • risk factors:
    • accidental ingestion
    • suicidal ideation

PATHOGENESIS:

1. Petroleum-Distillate Hydrocarbons (PDH)

  • are not significantly absorbed through the gastrointestinal tract with local or systemic toxicity only as a result of aspiration - gasoline, kerosene, charcoal lighter fluid, mineral seal oils (furniture polish), naphthas (lighter fluid, paint thinner), benzine (petroleum ether)
  • furniture polish has a very low viscosity and thus aspiration of a small quantity (0.1-0.2cc) may involve a large surface area causing interstitial inflammation, hyperemia, and alveolar necrosis

2. Nonpetroleum-Distillate Hydrocarbons (NPDH)

  • significant absorption throught the gastrointestinal tract causing systemic toxicity
  • turpentine, xylene, benzene, toulene

CLINICAL FEATURES:

1. Local Toxicity

1. Respiratory Manifestations

  • mucous membrane irritation
  • aspiration pneumonitis
    • choking, gagging, vomiting
    • cough, hemoptysis
    • fever (may persist for up to 10 days)

2. Systemic Toxicity

1. Neurological Manifestations

  • acute ataxia
  • CNS depression
  • euphoria
  • headache
  • vertigo

2. Others

  • congestive heart failure
  • hepatic/renal/hematologic toxicity

INVESTIGATIONS:

1. Imaging Studies

1. Chest X-Ray

  • may be unremarkable up to 8-12 hours post-ingestion
  • usually see infiltrates by 2-3 hours post-ingestion
  • pneumatoceles may appear 2-3 weeks post-ingestion

2. Serum

  • leukocytosis on CBC
  • liver function tests, electrolytes, BUN, creatinine

MANAGEMENT:

I. INITIAL MANAGEMENT

  • A. Airway
  • B. Breathing
  • C. Circulation
    • if hemodynamically unstable
    • Normal Saline or Ringers at 10-20 cc/kg IV over 1 hour
  • D. Draw Blood
    • gas, electrolytes, BUN, Creatinine, CBC, liver function tests (AST, ALT, albumin)
  • E. Eliminate
    • syrup of ipecac, gastric lavage, activated charcoal, and cathartics are all contraindicated

    • II. MAINTENANCE THERAPY

    1. Respiratory Manifestations

    • if by 6 hours post-ingestion there are no respiratory problems and the chest x-ray is normal, discharge home with follow-up chest x-ray at 2-3 weeks
    • if there are respiratory manifestations or changes on chest x-ray, hospitalize for observation with symptomatic and supportive care
    • do not use corticosteroids or prophylactic antibiotics

    2. Complications

    • moniter gases, electrolytes, BUN, creatinine, CBC, liver function tests
    • supportive care for cardiovascular, hepatic, renal, and haematological complications

     

     

    Pediatric Database - HYDROCARBON TOXICITY

     

    Pediatric Organization - Pedbase [at] Gmail.com

     
    1994 -2007 Pedbase.org 

    Powered by Database of Pediatrics- HYDROCARBON TOXICITY