THE TREATMENT OF PHOSGENE POISONING WITH TRACHEOTOMY AND SUCTION

Abstract

A series of dogs poisoned by exposure to phosgene gas were treated by tracheotomy and suction applied by insertion of a catheter deep into the trachea. By this method of treatment, animals were brought out of a moribund condition and the survival time was definitely increased. The survival rate, however, was essentially the same as that of the control animals. Although digitalis augments the heart beat, clears up irregularities, and keeps the heart beating for a time after respiration has failed, it may be detrimental by increasing the effusion of the fluid into the lung rather than decreasing it. The higher the pregassing concentration of haemoglobin the smaller the amount of fluid that effused into the lungs and the greater was the chance of survival. In practically all animals the point at which haemoconcentration reached a maximum was between 22 and 23 gm. of haemoglobin per 100 mils of blood. On post-mortem examination of dogs dying from phosgene poisoning the stomach was found to be markedly distended with gas and the vessels congested. This adds to the embarrassment of respiration and circulation. The big problem in the treatment of phosgene poisoning is still the finding of some substance or means of limiting or preventing the effusion of fluid into the airways of the lung.