Five Successful Experiences in the Treatment of Charcoal Aspiration with Bronchoscopic Toilet -A Case Report-
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Although activated charcoal is an effective treatment for most toxic ingestions, aspiration of activated charcoal can be fatal. Here, we report that in 5 charcoal aspiration cases, bronchoscopy with suction and lavage was an effective way to remove charcoal from the lungs. Patients showed high APACHE II scores (range: 10－29), and either low PO2 levels, or low CO2 retention. After bronchoscopic removal of the aspirated charcoal, symptoms of hypoxia, CO2 retention, localized wheezing, and pneumonic infiltration as determined by chest radiography, improved in most patients. We report 5 cases of successful treatment of charcoal aspiration with bronchoscopic toilet.
Abstract
Although activated charcoal is an effective treatment for most toxic ingestions, aspiration of activated charcoal can be fatal. Here, we report that in 5 charcoal aspiration cases, bronchoscopy with suction and lavage was an effective way to remove charcoal from the lungs. Patients showed high APACHE II scores (range: 10－29), and either low PO2 levels, or low CO2 retention. After bronchoscopic removal of the aspirated charcoal, symptoms of hypoxia, CO2 retention, localized wheezing, and pneumonic infiltration as determined by chest radiography, improved in most patients. We report 5 cases of successful treatment of charcoal aspiration with bronchoscopic toilet.
참고문헌 (16)
- Moll J, "Incidence of aspiration pneumonia in intubated patients receiving activated charcoal", J Emerg Med, 17, pp.279~283 (1999)
- Heard K, "The changing indications of gastrointestinal decontamination in poisonings", Clin Lab Med, 26, pp.1~12 (2006)
- Vale J, "Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists", J Toxicol Clin Toxicol, 37, pp.731~751 (1999)
- Isbister GK, "Application of pharmacokinetic-pharmacodynamic modeling in management of QT abnormalities after citalopram overdose", Intensive Care Med, 32, pp.1060~1065 (2006)
- Arnold TC, "Aspiration of activated charcoal elicits an increase in lung microvascular permeability", J Toxicol Clin Toxicol, 37, pp.9~16 (1999)
- Elliott CG, "Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal", Chest, 96, pp.672~674 (1989)
- 김수현, "활성숯 흡인 후 발생한 화학성 폐장염과 동반된 급성호흡곤란증후군-증례 보고-", 대한중환자의학회지, 25(2), pp.112~117 (2010), 대한중환자의학회
- Huber M, "Lung disease 35 years after aspiration of activated charcoal in combination with pulmonary lymphangioleiomyomatosis. A histological and clinicopathological study with scanning electron microscopic evaluation and element analysis", Virchows Arch, 449, pp.225~229 (2006)
- Visscher DW, "Bronchiolitis: the pathologist's perspective", Proc Am Thorac Soc, 3, pp.41~47 (2006)
- Arnold TC, "Pressure-controlled ventilation attenuates lung microvascular injury in a rat model of activated charcoal aspiration", J Toxicol Clin Toxicol, 41, pp.119~124 (2003)
- Golej J, "Severe respiratory failure following charcoal application in a toddler", Resuscitation, 49, pp.315~318 (2001)
- Pollack MM, "Aspiration of activated charcoal and gastric contents", Ann Emerg Med, 10, pp.528~529 (1981)
- Schreiber T, "PEEP has beneficial effects on inflammation in the injured and no deleterious effects on the noninjured lung after unilateral lung acid instillation", Intensive Care Med, 32, pp.740~749 (2006)
- Perkins GD, "In vivo and in vitro effects of salbutamol on alveolar epithelial repair in acute lung injury", Thorax, 63, pp.215~220 (2008)
- Broadley KJ, "Beta-adrenoceptor responses of the airways: for better or worse?", Eur J Pharmacol, 533, pp.15~27 (2006)
- Francis RC, "Acute respiratory failure after aspiration of activated charcoal with recurrent deposition and release from an intrapulmonary cavern", Intensive Care Med, 35, pp.360~363 (2009)