Kerosene-induced severe acute respiratory failure in near drowning: Reports on four cases and reviec of the literature

David Segev, Oded Szold, Elizabeth Fireman, Yoram Kluger, Patrick Sorkine

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: The purpose of this study is to present an unusual respiratory and cardiovascular course after intoxication and near drowning in a river contaminated with kerosene. Design: Case reports and review of the literature. Setting: Intensive care unit of a university-affiliated hospital. Patients: Four patients after near drowning. Intervention: Supportive only. Results: The four patients developed acute respiratory failure. Cardiomyopathy was present in three patients and a persistent hypokalemia in two patients. The onset of the symptoms was delayed, which led to underestimation of the severity of their illness. Two of the four patients died. The diagnosis of hydrocarbon intoxication was based on bronchoalveolar lavage results, neutrophilic alveolitis with the presence of lipid-laden macrophages, and evidence of lipoid pneumonia from the autopsy performed on one victim. One patient who clinically deteriorated and another who developed a severe restrictive pulmonary disorder were treated with corticosteroids, which were effective only in the latter patient. Conclusions: Acute kerosene intoxication in a near-drowning event often results in severe respiratory and cardiac failure, with a high fatality rate. Treatment with corticosteroids may lead to a rapid improvement in lung function.

Original languageEnglish
Pages (from-to)1437-1440
Number of pages4
JournalCritical Care Medicine
Volume27
Issue number8
DOIs
StatePublished - 1999
Externally publishedYes

Keywords

  • Adult respiratory distress syndrome
  • Cardiac failure
  • Corticosteroids
  • Hydrocarbon
  • Kerosene
  • Respiratory failure

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