Injuria por Inhalación Aguda, Conclusiones

La injuria por inhalación aguda es un diagnóstico sindromático con causas y consecuencias diversas. El conocimiento de la fisiopatología, factores y situaciones de riesgo, permitirá al clínico establecer una más precisa valoración. Desafortunadamente aún se requiere más información e investigación sobre esta entidad que genera muchas preguntas relacionadas con la susceptibilidad individual, los mecanismos de daño y los factores de riesgo para secuelas crónicas, donde incluso, se puede hacer referencia a desarrollo de cáncer y fibrosis pulmonar.


1. Miller K, Chang A. Acute inhalation injury. Emerg Med Clin North Am 2003; 21: 533-557.
2. Weill H. Disaster at Bhopal: The accident, early findings and respiratory health outlook in those injured. Bull Eur Physiopathologic Respiratoire 1987; 23: 587-90.
3. Baxter PJ, Kapila M, Mfonfu D. Lake Nyos disaster, Cameroon, 1986: the medical effects of large scale emission of carbon dioxide?. BMJ 1989; 298: 1.437-1.441.
4. Levin S, Herbert R, Skloot G, Szeinuk J, Teirstein A, Fischler D et al. Health effects of World Trade Center site workers. Am J Ind Med 2002; 42: 545-547.
5. CDC. Injuries and illnesses among New York city fire department rescue workers after responding to the World Trade Center attacks. MMWR 2002; 51 (special issue): 1-5.
6. Schwartz DA. Acute inhalational injury. Occup Med 1.987; 2: 297-318.
7. Henneberger PK, Metayer C, Lyne LA, Althouse R. Nonfatal work- related inhalations: Surveillance data from hospital emergency departments, 1995- 1996. Am J Ind Med 2000; 38: 140-148.
8. Boulet L-P, Bowie D. Acute occupational respiratory diseases. Eur Respir Mon 1999; 11: 320-346.
9. Valent F, McGwin G Jr, Bovenzi M, Barbone F. Fatal work- related inhalation of harmful substances in the United States. Chest 2002; 121: 969-975.
10. Litovitz T, Oderda G, White JD, Sheridan MJ: Occupational and environmental exposures reported to poison centers. Am J Public Health 1993; 83: 739-743.
11. Blanc PD, Galbo M, Hiatt P, Olson KR. Morbidity following acute irritant inhalation in a population- based study. JAMA 1991; 266: 664-669.
12. Sallie B, McKonald C. Inhalation accidents reported to the SWORD surveillance project 1990- 1993. Ann Occup Hyg 1996; 40: 211-221.
13. Rabinowitz PM, Siegel MD. Acute inhalation injury. Clin Chest Med 2002; 23: 707-715.
14. Delclos GL, Carson AI. Acute gaseous exposure. In: Harber P, Schenker MB, Balmes JR. Occupational and environmental respiratory disease. St Louis, Missouri: Mosby- Year Book Inc. 1996; 514-534.
15. Schwartz DA. Toxic tracheitis, bronchitis and bronchiolitis. In: Hendrick DJ. Burge S, Beckett WS, Churg A. Occupational disorders of the lung. Recognition, management and prevention. London: WB Saunders 2002; 93-103.
16. Weiss SM, Lakshminarayan S. Acute inhalation injury. Clin Chest Med 1994; 15: 103-116.
17. Meggs WJ. RADS and RUDS- the toxic induction of asthma and rhinitis-. J Toxicol Clin Toxicol 1994; 32: 487-501.
18. Meggs WJ, Elsheik T, Metzger WJ, Albernaz M, Bloch RM. Nasal pathology and ultrastructure in patients with chronic airway inflammation (RADS and RUDS) following an irritant exposure. J Toxicol Clin Toxicol 1996; 34: 383-396.
19. Perkner JJ, Fennelli KP, Balkissoon R, Bartelson BB, Ruttenber AJ, Wood RP, Newman LS. Irritant- associated vocal cord dysfunction. J Occup Environm Med 1998; 40: 136-143.
20. Charan NB, Myers CG, Lakshminarayan S, Spencer TM. Pulmonary injuries associated with acute sulfur dioxide inhalation. Am Rev Respir Dis 1979; 119: 555-560.
21. Brooks SM, Lockey J. Reactive airways disease syndrome (RADS): A newly defined occupational disease {abstract}. Am Rev Respir Dis 1981; 123: (Suppl.): A133.
22. Chan- Yeung M. Assesment of asthma in the workplace. Chest 1995; 108: 1.084-1.117.
23. Henneberger PK, Derk SJ, Tumpowsky C, Reilly MJ, Rosenman KD et al. Work- related reactive airways dysfunction syndrome cases from surveillance in selected US States. J Occup Environ Med. 2003; 45: 360-368.
24. Alberts WM, Brooks SM. Reactive airways dysfunction syndrome. Curr Opin Pulm Med 1996; 2: 104-110.
25. Boulet LP. Increases in airway responsiveness following acute exposure to respiratory irritants. Chest 1988; 94: 476- 481.
26. Rabinovitch S, Greyson ND, Weiser W, Hoffstein V. Clinical and laboratory features of acute sulfur dioxide inhalation poisoning: Two- year follow up. Am Rev Respir Dis 1989; 139: 556-558.
27. Leduc D, Gris P, Lhereus P, Govenois PA, De Vuyst P, Yernault JC. Acute and long term respiratory damage following inhalation of ammonia. Thorax 1992; 47: 755-757.
28. De la Hoz RE, Schlueter DP, Rom W. Chronic lung disease secundary to ammonia inhalation injury: a report of three cases. Am J Ind Med 1996; 29: 209-214.
29. Winder C. The toxicology of chlorine.Environ Res 2001; 85: 105-114.
30. Kaufman J, Burkons D, Clinical, roentgenologic and physiologic effects of acute chlorine exposure. Arch Environ Health 1971; 23: 29-34.
31. Kraut A, Lilis R. Chemical pneumonitis due to exposure to bromine compounds. Chest 1988; 208-210.
32. Mrvos R, Dean BS, Krenzelok EP. Home exposures to chlorine/ chloramine gas: a review of 216 cases. South Med J. 1993; 86: 654-657.
33. Reisz GR, Gammon RS. Toxic pneumonitis from mixing household cleaners. Chest 1986; 89: 49-52.
34. Tanen DA. Severe lung injury after exposure to chloramine gas from household cleaners. N Engl J Med 1999; 341: 848- 849.
35. Kamat SR, Mahashur AA, Tiwari AK, Potdar PV, Gaur M, Kolhatkar VP et al. Early observations on pulmonary changes and clinical morbidity due to the isocyanate gas leak at Bhopal. J Postgrad Med 1985; 31: 63-72.
36. Mehta PS, Mehta As, Mehta SJ, Makhijani AB. Bhopal tragedy’s health effects. JAMA 1990; 264: 2.781-2.787.
37. Nemery B. Toxic pneumonitis: Chemical agents. In: Hendrick DJ. Burge S, Beckett WS, Churg A. Occupational disorders of the lung. Recognition, management and prevention. London: WB Saunders 2002: 201-219.
38. Sjogren B, Plato N, Alexandersson R, Eklund A, Falkenberg C. Pulmonary reactions caused by welding- induced decomposed trichloroethylene. Chest 1991; 99: 237-238.
39. Snyder R, Mishel HS, Christensen GC III. Pulmonary toxicity following exposure to methylene chloride and its combustion product, phosgene. Chest 1992; 102: 1.921.
40. Douglas WW, Hepper NGG, Colby TV. Silo- filler’s disease. Mayo Clin Proc 1989; 64: 291-304.
41. Jinn Y, Akizuki N, Ohkouchi M, Inase N, Ichioka M, Marumo F. Acute lung injury after inhalation of water- proofing spray while smoking a cigarette. Respiration 1998; 65: 486-488.
42. Hubbs AF, Castranova V, MA JY, Frazer DG, Siegel PD, Ducatman BS et al. Acute lung injury induced by a commercial leather conditioner. Toxicol Appl Pramacol 1997; 143: 37-46.
43. Barnhart S, Rosenstock L. Cadmium chemical pneumonitis. Chest 1984; 86: 789-791.
44. Taylor A, Jackson MA, Burston J, Lee HA. Poisoning with cadmium fumes after smelting lead. Br Med J 1984; 288: 1.270-1.271.
45. Yates DH, Goldman KP. Acute cadmium poisoning in a foreman plate welder. Br J Ind Med 1990; 47: 429-431.
46. Levin M, Jacobs J, Polos PG. Acute mercury poisoning and mercurial pneumonitis from gold ore purification. Chest 1988; 94: 554-556.
47. Rowens B, Guerrero- Betancourt D, Goltlieb CA, Boyes RJ, Eichenhorn MS. Respiratory failure and death following acute inhalation of mercury vapor. A Clinical and histologic perspective. Chest 1991; 99: 185-190.
48. Gill JR, Ely SF, Hua Z. Environmental gas displacement. Three accidental deaths in the work place. Am J Forensic Med Pathol 2002; 23: 26-30.
49. Schmunk GA, Kaplan JA. Asphyxial deaths caused by automobile exhaust inhalation not attributable to carbon monoxide toxicity: Study of 2 cases. Am J Forensic Med Path 2002; 23: 123-126.
50. Ernst A, Zibrak JD. Carbon monoxide poisoning. New Engl J Med 1998; 339: 1.603-1.608.
51. Abelson A, Sanborn M, Jessiman BJ, Weir E. Identifying and managing adverse environmental health effects: 6. Carbon monoxide poisoning. CMAJ 2002; 166: 1.685-1.690.
52. Stewart RD, Hake CL. Paint- remover hazard. JAMA 1976; 235: 398-401.
53. Zhang J, Piantadosi CA. Mitochondrial oxidative stress after carbon monoxide hypoxia in the rat brain. J Clin Invest 1992; 90: 1.193-1.199.
54. Thom SR. Carbon monoxide- mediated brain lipid peroxidation in the rat. J App Physiol 1990; 68: 997-1.003.
55. Thom SR. Dehydrogenase conversion to oxidase and lipid peroxidation in brain after carbon monoxide poisoning. J Appl Physiol 1992; 73: 1.584-1.589.
56. Jaffe FA. Pathogenicity of carbon monoxide. Am J Forensic Med Pathol 1997; 18: 406-410.
57. Fisher J. Carbon monoxide poisoning. A disease of thousand faces. Chest 1999; 115: 322-323.
58. Choi IS. Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol 1983; 40: 433-435.
59. Min SK. A brain syndrome associated with delayed neuropsychiatric sequelae following acute carbon monoxide intoxication. Arch Neurol 1983; 40: 433-435.
60. Mokhlesi B. Leikin JB, Murray P, Corbridge TC. Adult toxicology in critical care. Part II: Speciic poisonings. Chest 2003; 123: 897-922.
61. Cherian MA. Fatal methane and cyanide poisoning as a result of handling industrial fish: a case report and review of the literature. J Clin Pathol 2000; 53: 794-795.
62. Campian EC, Cai J, Benz FW. Acrylonitrile irreversibly inactives glyceraldehyde- 3- phosphate dehydrogenase by alkylating the catalytically active cysteine 149. Cem Biol Interact. 2002; 140: 279-291.
63. Duong TX, Suruda AJ, Maier LA. Interstitial fibrosis following hydrogen sulfide exposure. Am J Ind Med 2001; 40: 221- 224.
64. Martin CJ, Guidotti TL, Langard S. Respiratory hazardas of welding. Clin Pulm Med 1997; 4: 194-204.
65. Antonini JM, Lewis AB, Roberts JR, Whaley DA. Pulmonary effects of welding fumes: Review of worker and experimental animal studies. Am J Ind Med 2003; 43: 350-360.
66. Blanc P, Bushey H. The lung in metal fume fever. Sem Respir Med 1993; 14: 212-225.
67. Sprout WL. Polymer- fume fever. J Occup Med 1988; 30: 296.
68. Shusterman DJ. Polymer fume fever and other fluorocarbon pyrolysis- related syndromes. Occup Med 1993; 8: 519-531.
69. Albrecht WN, Bryant CJ. Polymer- fume fever associated with smoking and use of a mold- release spray containing polytetrafluoroethylene. J Occup Med 1987; 29: 817-819.
70. Silver MJ, Young DK. Acute noncardiogenic pulmonary edema due to polymer fume fever. Cleve Clin J Med 1993; 60: 479- 482.
71. Seifert SA, Von Essen S, Jacobitz K, Crouch R, Lintner CP. Organic dust toxic syndrome: A review. J Toxicol Clin Toxicol 2003; 41 (2): 185-193.
72. Iversen M. toxic Pneumonitis: ‘Organic’ agents. In: Hendrick DJ, Burge S, Beckett WS, Churg A. Occupational disorders of the lung. Recognition, management and prevention. London: WB Saunders 2002: 201-219.
73. Sanz- Gallens, Nogue S, Munne P, Faraldo A. Hypocalcemia and hypomagnesaemia due to hydrofluoric acid. Occup Med 2001; 51: 294-295.
74. Greco RJ, Hartford CE, Haith LR Jr, Patton ML. Hydrofluoric acid- induced hypocalcemia. J trauma 1988; 28: 1.593-1.596.
75. Cullinan P, Newman Taylor A.J. Acute toxic chemical exposures: mechanisms and outcomes. In: Banks DE, Parker JE. Occupational lung disease. London: Chapman & Hall. 1998: 453-463.
76. Jones RN Hughes JM, Glindmeyer H, Weill H. Lung function after acute chlorine exposure. Am Rev respir Dis 1986; 134: 1.1190-1.195.
77. Hasan FM, Gehshan A, fuleihan FJD. Resolution of pulmonary dysfunction following acute chlorine exposure. Arch Environ Health 1983; 38: 76-80.
78. Ploysonang Y, Beach BC, Dilisio RE. Pulmonary function changes after acute inhalation of chlorine gas. South Med J 1982; 75: 23-26.
79. Schwartz DA, Smith DD, Lakshminarayan S. The pulmonary sequelae associated with accidental inhalation of chlorine gas. Chest 1990; 97: 820-825.
80. Dixon M, Jackson DM, Richards IM. Changes in the bronquial reactivity of dogs caused by exposure to sulfur dioxide. J Physiol 1983; 337: 89-99.
81. Riedel F, Kramer M, Scheibenbogen C, Rieger CH. Effects of SO2 exposure on allergic sensitization in the guinea pig. J Allergy Clin Immunol 1988; 82: 527-534.
82. Wolff RK, Osminski G, Newhouse MT. Acute exposure of symptomatic steelworkers to sulfur dioxide and carbon dioxide: effects on mucociliary transport, pulmonary function and bronchial reactivity. Br J Ind Med 1984; 41: 499-505.
83. Golden JA, Nadel JA, Boushey HA. Bronchial hyperreactivity in healthy subjects after exposure to ozone. Am Rev Respir Dis 1978; 118: 287-294.
84. Harkonen H, Nordman H, Korhonen O, Winblad I. Long term effects of exposure to sulfur dioxide. Lung function four years after a pyrite dust explosion. Am Rev Respir Dis 1983; 128: 890-893.
85. Shirani KZ, Pruitt BA, Mason AD. The influence of inhalation injury and pneumonia on burn mortality. Ann Surg 1987; 205; 82-87.
86. Wright JL. Inhalational lung injury causing bronchiolitis. Clin Chest Med 1993; 14: 635-644.
87. Teixidor HS, Novick G, Rubin E. Pulmonary complications in burn patients. J Can Assoc Radiol 1983; 34: 264-270
88. Fogarty PW, George PJ, Solomon M, Spiro SJ, Armstrong RF. Ong term effects of smoke inhalation in survivors of the King’s Cross underground station fire. Thorax 1991; 46: 914- 918.
89. Park GY, Parg JW, Jeong DH, Jeong SH. Prolonged airway and systemic inflammatory reactions after smoke inhalation. Chest 2003; 123: 475-480.
90. Hantson P, Butera R, Clemssy J-L, Michel A, Baud FJ. Early complications and value of initial clinical and paraclinical observations in victims of smoke inhalation without burns. Chest 1997; 111: 671-675.
91. Meisels IS, Loke J. The pulmonary effects of free- base cocaine: a review. Cleve Clin J Med 1993; 60: 325-329.
92. Haim DY, Lippmann ML, Goldberg SK, Waldenstein MD. The pulmonary complications of crack cocaine. A Comprensive review. Chest 1995; 107: 233-240.
93. Silverman RS, Lee- Chiong TL Jr, Sherter CB. Stridor from edema of the arytenoids, epiglottis and vocal cords after use of free- base cocaine. Chest 1995; 108: 1.477-1.478.
94. Mayo- Smith MF, Spinale J. Thermal epiglottitis in adults: a new complication of illicit drug use. J Emerg Med 1997; 15: 483-485.
95. Wesselius LJ. Pulmonary disorders associated with use of illicit drugs. Clin Pulm Med 1997; 4: 71-75.
96. Bailey ME, Fraire AE, Greenberg SD, Barnard J, Cagle PT. Pulmonary histopathology in cocaine abusers. Hum Pathol 1994; 25: 203-207.
97. Allred RJ, Ewew S. Fatal pulmonary edema following intravenous freebase cocaine use. Ann Emerg Med 1981; 10: 441-442.
98. Cucco RA, Yoo OH, Gregler L et al. Non fatal pulmonary edema after “freebase”cocaine smoking. Am Rev Respir Dis 1987; 136: 179-81.
99. Kissner DG, Lawrence WD, Selis JE, Flint A. Crack lung: Pulmonary disease caused by cocaine abuse. Am Rev Respir Dis 1987; 136: 1.250-1.252.
100.Tashkin DP. Airway effects of marijuana, cocaine and other inhaled illicit agents. Curr Opin Pulm Med 2001; 7: 43-61.
101.Prezant DJ, Weiden M, Banauch GI, McGuinnes G, Rom WN, Aldrich TK et al. Cough and bronchial responsiveness in firefighters at the World Trade Center site. N Engl J Med 2002; 347: 806-815.
102.Banauch GI, Alleyne D, Sanchez R, Olender K, Cohen HW, Weiden M, et al. Am J Respi Crit Care Med 2003; 168: 54-62.
103.Rom WN, Weiden M, Garcia R, Ting AY, Vathesatogkit P, Tse DB et al. Acute eosinophilic pneumonia in a New York city firefighter exposed to World Trade Center Dust. Am J Resp Crit Care Med 2002; 166: 797-800.



Por favor ingrese su comentario!