Aspiration Of Lamp Oil Research Articles

Pediatric Lamp Oil Injuries Treated in US Emergency Departments.

Ingestion and aspiration of lamp oil may result in serious adverse effects and even death. The objective of this study was to describe pediatric lamp oil-related injuries treated at US emergency departments (EDs). Cases were lamp oil-related injuries among patients aged 0 to 5 years reported to the National Electronic Injury Surveillance System during 2001-2018. The distribution of the number of cases and national estimate were determined for selected variables. A total of 317 pediatric lamp oil-related injuries treated at US EDs during 2001-2018 were identified, resulting in a national estimate of 9501 injuries (95% confidence interval, 6937-12,065). The national estimate declined from 1599 in 2001 to 59 in 2014 before increasing once more to 596 in 2017. The patients were 5.4% aged less than 1 year; 62.2%, 1 year; 23.0%, 2 years; 6.6%, 3 years; 2.2%, 4 years; and 0.6%, 5 years; 68.6% of the patients were boys and 31.4% were girls. Ingestions accounted for 91.9% of the injuries, and 82.1% occurred at home. The disposition of the patient was treated or examined and released (68.2%), treated and transferred to another hospital (13.2%), treated and admitted for hospitalization (14.4%), held for observation (4.2%), and not recorded (0.1%). Although the estimated number of lamp oil-related injuries declined during 2000-2014, it increased during 2015-2017. Most of the patients were aged 1 to 2 years and boys. The majority of the injuries occurred by ingestion and at home. Most of the patients were treated or evaluated and released from the ED.

Early Administration of Intratracheal Surfactant (Calfactant) After Hydrocarbon Aspiration

Hydrocarbon ingestions account for a substantial number of accidental poisonings; when aspirated, it can lead to severe pneumonitis. Treatment for severe pneumonitis is generally supportive, and outcomes are frequently poor. We report here the case of a 19-month-old girl who was treated successfully with early administration of exogenous surfactant for acute respiratory distress syndrome secondary to aspiration of lamp oil. Approximately 7 hours after aspiration, she required mechanical ventilation and had an oxygenation index (OI) of 13.2. Approximately 10 hours after ingestion, exogenous surfactant (calfactant) was instilled intratracheally, after which her OI improved markedly to 4.3. She received a second dose ∼19 hours after ingestion, after which her OI remained at <5 and she was progressively weaned from mechanical ventilation. She was extubated 64 hours after the ingestion with no residual lung disease. This case illustrates the importance of considering exogenous surfactant therapy early in the course of acute respiratory failure secondary to hydrocarbon aspiration. Because of the putative mechanisms of lung injury involved in hydrocarbon aspiration, surfactant-replacement therapy is a reasonable therapeutic intervention based on pathophysiologic rationale.

Fire eater's pneumonia characterized by pneumatocele formation and spontaneous resolution

Liquid hydrocarbons derived from petroleum are widely used in industry and in households. Aspiration of massive amounts may lead to an acute and fatal form of exogenous lipoid pneumonia (fire-eater's pneumonia). We present a rare case of chemical pneumonitis following accidental lamp oil aspiration characterized by pneumatocele formation and spontaneous resolution. Initial findings on posteroanterior chest radiographs were smoothly circumscribed lower zone masses with and without air-fluid levels. Chest computed tomography also showed multiple thin-walled cavities with and without air-fluid levels. Complete resolution of findings despite initial severe presentation without corticosteroid or antibiotic treatment is noteworthy.

Pneumonitis and pneumatoceles following accidental hydrocarbon aspiration in children

Accidental ingestion and aspiration of hydrocarbons in children are common. Among the various clinical and pathological manifestations of hydrocarbon (HC) poisoning, pneumonitis is the most significant and occurs in up to 40% of children, whereas formation of pneumatoceles is believed to be a rare event. We report two children with HC pneumonitis and pneumatoceles as a reversible complication after ingestion and aspiration of lamp oil with very low viscosity. Patient 1, a 21-month-old boy, started to cough and developed tachypnea, sternal retractions and mild cyanosis immediately after aspiration. Patient 2, a 24-month-old girl, was asymptomatic during the first days after the accident; subsequently, she started to cough and developed fever, dyspnea and chest pain. Chest x-ray and computed tomography revealed multiple patchy infiltrates in both cases; after several days, these confluent infiltrates developed into pneumatoceles. Both children were treated with antibiotics and steroids. They recovered within three and four weeks, respectively, with complete remission of the radiologic abnormalities and had an uneventful follow-up after discharge.

Assessment of the acute pulmonary toxicity of lamp oil aspiration in the isolated perfused rat lung

Mainly among children incidental ingestion of conventional lamp oils (paraffin oil) is responsible for casual intoxications with severe pulmonary toxicity and fatal consequences. On the basis of the isolated blood-free perfused rat lung we developed a model to study the acute toxic effects of lamp oil. Three oils were studied: conventional paraffin lamp oil (kinematic viscosity 1.62 10 −6 m 2/sec), the methyl ester Edenor® ME C12 70 (2.7 10 −6 m 2/s) and another ester Edenor® LPL (4.5 10 −6 m 2/s). The oils were instilled into the trachea of isolated rat lungs and the changes in lung mechanics (tidal volume, pulmonary compliance and pulmonary conductance) as well as edema formation (increase in lung weight) studied. Instillation of as little as 10 μl paraffin oil caused complete failure of lung functions within 20 min and even 2 μl caused noticeable edema. Similar results were obtained with Edenor® ME C12 70, which appeared to be even more toxic than paraffin oil, while Edenor® LPL was less toxic. We conclude that tracheal instillation of oils into isolated perfused rat lungs may be a useful model to study the toxicity of lamp oils in vitro. Our findings further suggest that Edenor® LPL may be a safer alternative for use as a lamp oil than paraffin oil.