ARDS after accidental inhalation of zinc chloride smoke

Five soldiers were injured by inhalation of hexite smoke (ZnCl2) during military training. Two soldiers, not wearing gas masks breathed hexite for 1 or 2 min, they slowly developed severe adult respiratory distress syndrome (ARDS) over the ensuing 2 weeks. This slow, progressive clinical course has...

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Bibliographic Details
Published in:Intensive care medicine 1988, Vol.14 (1), p.17-24
Main Authors: HJORTSO, E, QVIST, J, BUD, M. I, THOMSEN, J. L, ANDERSEN, J. B, WIBERG-JORGENSEN, F, GENSEN, N. K, JONES, R, REID, L. M, ZAPOL, W. M
Format: Article
Language:English
Subjects:
Acetylcysteine - therapeutic use
Adult
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Biological and medical sciences
Chemical and industrial products toxicology. Toxic occupational diseases
Chlorides - poisoning
Gas, fumes
Humans
Lung - analysis
Lung - blood supply
Lung - pathology
Medical sciences
Military Personnel
Respiratory Distress Syndrome, Adult - chemically induced
Respiratory Distress Syndrome, Adult - pathology
Toxicology
Zinc - analysis
Zinc - poisoning
Zinc Compounds
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Summary:Five soldiers were injured by inhalation of hexite smoke (ZnCl2) during military training. Two soldiers, not wearing gas masks breathed hexite for 1 or 2 min, they slowly developed severe adult respiratory distress syndrome (ARDS) over the ensuing 2 weeks. This slow, progressive clinical course has not been previously described. In both patients, an increased plasma zinc concentration was measured 3 weeks after the incident. Intravenous and nebulized acetylcysteine increased the urinary excretion of zinc, and briefly decreased the plasma levels. In an attempt to arrest collagen deposition in the lungs, L-3,4 dehydroproline was administered. Both patients died of severe respiratory failure (25 and 32 days after inhalation). At autopsy diffuse microvascular obliteration, widespread occlusion of the pulmonary arteries and extensive interstitial and intra-alveolar fibrosis was observed. Three soldiers wearing ill fitting gas masks, immediately developed severe coughing and dyspnea. They improved, and 12 months after exposure their lung function tests were nearly normal, but they still had slight dyspnea on exercise.
ISSN:0342-4642
1432-1238
DOI:10.1007/BF00254116