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Poisoning with hydrocarbons: symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Hydrocarbon poisoning occurs when swallowed or inhaled. Ingestion is more common in children <5 years of age and may cause aspiration pneumonitis. Inhalation, more common in adolescents, can lead to ventricular fibrillation, usually without any previous symptoms. Diagnosis of pneumonitis is established by clinical data, chest X-ray and oximetry. Emptying the stomach is contraindicated due to the risk of aspiration. Treatment is supportive.
The ingestion of hydrocarbons, such as petroleum distillates (for example, gasoline, kerosene, mineral oil, lamp oil, solvents), causes minimal systemic effects, but can cause severe aspiration pneumonitis. The degree of toxicity depends mainly on the viscosity measured in the universal seconds of Saybolt (CSS). Liquid hydrocarbons with low viscosity (CCG <60), such as gasoline and mineral oil, can quickly spread over a large area and are more likely to cause respiratory pneumonitis than hydrocarbons with CCG> 60, such as tar. Hydrocarbons ingested in large quantities, as a result of systemic absorption, can cause toxic CNS or liver damage, which most often occur due to halogenated hydrocarbons (for example, carbon tetrachloride, trichlorethylene).
Inhalation of halogenated hydrocarbons (for example, paints, solvents, cleaning sprays, gasoline, fluorocarbons used as refrigerants or propellants in aerosols) is common among adolescents. It can cause euphoria and changes in mental status and increases the sensitivity of the heart to endogenous catecholamines. This can result in fatal ventricular arrhythmias, which usually develop without a prodromal palpitation or other warning signs, often when the patient is frightened or runs away.
[Symptoms of hydrocarbon poisoning
After swallowing even a very small amount of liquid hydrocarbon, patients initially begin coughing, choking, and possible vomiting. In young children, there is cyanosis, respiratory arrest and a persistent cough. Children of senior school age and adults can report a burning sensation in the stomach. Aspiration pneumonitis causes hypoxia and respiratory distress syndrome. Symptoms of pneumonitis can develop a few hours before the formation of infiltrates visible on radiographs. Significant systemic absorption, especially of a halogenated hydrocarbon, can cause disturbances in consciousness, convulsions and coma. Nonfatal pneumonitis usually occurs within a week. After poisoning with mineral or lamp oil, recovery usually occurs within 5-6 weeks. After elimination of the cause, arrhythmias usually do not recur.
If the patient's condition does not allow you to make an anamnesis, the assumption can be made by smelling from the mouth and from clothing or by the presence of a number of containers from the hydrocarbon. On the remnants of paint on the hands or around the mouth, it can be assumed that the paint was sniffed. The diagnosis of aspiration pneumonitis is established by clinical data, chest X-ray and oximetry, which are carried out approximately 6 hours after the poisoning or earlier if the symptoms are severe. If the suspected respiratory failure is determined by the gas composition of the blood.
Treatment of poisoning with hydrocarbons
All contaminated clothing is removed, and the skin is laundered.
Caution: Emptying the stomach, which increases the risk of aspiration, is contraindicated.
Activated charcoal is not recommended. Patients without aspiration pneumonitis and other symptoms within 4-6 hours can be released, otherwise hospitalization is indicated. Treatment is supportive, antibiotics and glucocorticoids are not indicated.