Phosgene: a practitioner's viewpoint.
Clinical experience with five patients exposed to phosgene is described. The treatment of phosgene poisoning was focused upon the presenting problem, pulmonary edema. Arterial hypoxemia was treated with a face mask with 10 cm CPAP with the FiO2 adjusted as needed or with a volume ventilator with controlled ventilation. Ventilation was controlled to reduce the work of breathing. Metabolic acidosis was treated with NaCHO3 to produce a normal pH. A vigorous program of diuresis was used to treat the pulmonary edema. Lasix was administered to produce a negative fluid balance while maintaining a good urinary output. The negative fluid balance correlated well with reduced oxygen requirements.
D000137:Acid-Base Imbalance / Q000188:drug therapy / Q000209:etiology; D000328:Adult; D001639:Bicarbonates / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005665:Furosemide / Q000627:therapeutic use; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000628:therapy; D007819:Laryngeal Edema / Q000139:chemically induced; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced / Q000628:therapy; D010102:Oxygen Inhalation Therapy; D010705:Phosgene / Q000506:poisoning*; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000150:complications / Q000628:therapy; D012964:Sodium / Q000627:therapeutic use; D017693:Sodium Bicarbonate
D001639:Bicarbonates; D010705:Phosgene; D005665:Furosemide; D017693:Sodium Bicarbonate; D012964:Sodium