Acute Respiratory Distress Syndrome Caused by Ingestion of a Toilet-Bowl Cleaner Containing Sodium Hypochlorite
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There have been many reports of digestive tract injuries following ingestion of toilet-bowl cleaners containing sodium hypochlorite (SHC), but there have few reports of acute respiratory distress syndrome (ARDS). A 72-year-old woman ingested a toilet-bowl cleaner to commit suicide. Physical examination on admission revealed erythema of the oral cavity and moist rales over both lung fields. Mechanical ventilation through an endotracheal tube was started immediately. Eight hours after admission, the PaO2/FIO2 ratio had decreased to 185mmHg and a chest X-ray showed bilateral infiltrates. Continuous infusion of Sivelestat sodium was started to treat the ARDS, and on day 8, mechanical ventilation was discontinued. After ingestion, SHC may directly induce ARDS by the exacerbation of chemical pneumonia by aspiration. Hydrochloric acid and chlorine gas produced by SHC may induce ARDS. In addition, SHC may deplete reduced glutathione in the lungs, and the depletion may induce ARDS. Patients who have ingested a toilet-bowl cleaner containing SHC should be examined for ARDS.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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