Pulmonary oedema after acute poisoning

A 58 year old man accidentally fell, face first, into a reservoir of trichloroethylene at work. He was rescued by a work colleague and it was estimated that he had been in the reservoir for about 3-5 minutes. On admission to hospital he had 30% burns mainly to his face, buttocks and back. He was deeply comatose and tachycardic. His pharynx and larynx were found to be markedly oedematous. Chest X-ray showed evidence of diffuse chemical pneumonitis. Liver enzymes were slightly elevated but renal function was normal. A gastric lavage was performed and respiratory depression necessitated mechanical ventilation. His level of consciousness gradually recovered and he was successfully extubated on day 24. There was no evidence of pneumonitis on chest X-ray on day 25 and the patient was eventually discharged in good health on day 44 (Yoshida et al., 1996).

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