Acute respiratory distress syndrome due to exposure to high-concentration mixture of ethenone and crotonaldehyde

Toxicol Ind Health. 2015 Jul;31(7):585-7. doi: 10.1177/0748233713480205. Epub 2013 Feb 28.

Abstract

Introduction: Acute inhalational exposure leads to rapidly progressive acute respiratory distress syndrome (ARDS). This report is the first one to present a patient with ARDS in relation to long-standing exposure to a high-concentration mixture of ethenone and crotonaldehyde.

Case report: A male worker in a chemical plant was accidentally exposed to the mixture of high-concentrated ethenone and crotonaldehyde for 5 min in an open space and worked continuously in the polluted area for approximately 12 h. On admission, he was conscious with the following vital parameters: blood pressure, 151/91 mmHg; pulse rate, 107 beats/min; respiratory rate, 30 breaths/min; temperature, 37.6°C; oxygen saturation, 92% supported by mask saturation 10 L/min; arterial blood gases showed P/F oxygen ratio of less than 200. Physical examination disclosed decreased bilateral vesicular sounds. A chest computed tomography revealed bilateral nonsegmental ground-glass opacities. The patient was mechanically ventilated and treated with corticosteroid. The patient was discharged without any symptoms.

Conclusion: Exposure to mixtures of ethenone and crotonaldehyde can cause severe pulmonary injury leading to delayed ARDS.

Keywords: ARDS; Acute lung injury; acute inhalation injury; acute inhalational exposure; corticosteroid.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aldehydes / adverse effects*
  • Ethylenes / adverse effects*
  • Humans
  • Inhalation Exposure / adverse effects
  • Ketones / adverse effects*
  • Male
  • Middle Aged
  • Occupational Exposure / adverse effects*
  • Respiration, Artificial
  • Respiratory Distress Syndrome / chemically induced*
  • Respiratory Distress Syndrome / diagnosis
  • Respiratory Distress Syndrome / drug therapy
  • Tomography Scanners, X-Ray Computed
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Aldehydes
  • Ethylenes
  • Ketones
  • 2-butenal
  • ketene