Hydrocarbon poisoning in pediatric practice

Abstract

The review presents data on the epidemiology of poisoning by petroleum products, their chemical and toxicological characteristics, clinical and radiological signs, and considers issues of treatment and prognosis. Numerous studies show the world-wide prevalence of hydrocarbon poisoning in children under 5 years of age. The largest number of messages comes from the regions of the Middle East and South Asia. The mechanisms of pathogenesis and clinical manifestations of poisoning by such petroleum distillates as gasoline and kerosene are well studied. In the last two decades, poisoning with ignition fluids, which are a mixture of saturated hydrocarbons, has been relevant for the Russian Federation. Their toxic effect upon oral administration is realized mainly through the development of aspiration pneumonitis, which is clinically manifested by cough and respiratory failure. Systemic effects are not typical, and neurological disorders are associated primarily with pulmonary hypoxia. A significant risk factor for severe aspiration is the presence of vomiting, attempts to induce it, and gastric lavage. One of the rare but characteristic manifestations of lung damage in hydrocarbon poisoning is the formation of a pneumatocele. Treatment for hydrocarbon poisoning has not been developed enough; respiratory support plays a leading role, in severe cases, early mechanical ventilation. Infusion therapy is not a means of detoxification, and, if carried out to fill the physiological need, should be carried out in a limited amount due to the risk of pulmonary edema. The effectiveness of antibiotics and glucocorticosteroids has not been established. In most cases, hydrocarbon poisoning ends in recovery, lethal outcomes are observed in rare cases. An unfavorable prognosis can be determined, first, by massive aspiration, as well as the presence of alcohols, unsaturated, halogenated and aromatic compounds in the composition of the liquid taken.