Synthetic smoke with acrolein but not HCl produces pulmonary edema.
The chemical toxins in smoke and not the heat are responsible for the pulmonary edema of smoke inhalation. We developed a synthetic smoke composed of carbon particles (mean diameter of 4.3 microns) to which toxins known to be in smoke, such as HCl or acrolein, could be added one at a time. We delivered synthetic smoke to dogs for 10 min and monitored extravascular lung water (EVLW) accumulation thereafter with a double-indicator thermodilution technique. Final EVLW correlated highly with gravimetric values (r = 0.93, P less than 0.01). HCl in concentrations of 0.1-6 N when added to heated carbon (120 degrees C) and cooled to 39 degrees C produced airway damage but no pulmonary edema. Acrolein, in contrast, produced airway damage but also pulmonary edema, whereas capillary wedge pressures remained stable. Low-dose acrolein smoke (less than 200 ppm) produced edema in two of five animals with a 2- to 4-h delay. Intermediate-dose acrolein smoke (200-300 ppm) always produced edema at an average of 147 +/- 57 min after smoke, whereas high-dose acrolein (greater than 300 ppm) produced edema at 65 +/- 16 min after smoke. Thus acrolein but not HCl, when presented as a synthetic smoke, produced a delayed-onset, noncardiogenic, and peribronchiolar edema in a roughly dose-dependent fashion.
Hales
C A
CA
Department of Medicine (Pulmonary Unit), Massachusetts General Hospital, Boston.
Barkin
P W
PW
Jung
W
W
Trautman
E
E
Lamborghini
D
D
Herrig
N
N
Burke
J
J
D000171:Acrolein / Q000633:toxicity*; D000447:Aldehydes / Q000633:toxicity*; D000818:Animals; D001784:Blood Gas Analysis; D001794:Blood Pressure; D001810:Blood Volume; D002302:Cardiac Output; D004285:Dogs; D005110:Extracellular Space / Q000378:metabolism; D006358:Hot Temperature; D006851:Hydrochloric Acid / Q000633:toxicity*; D006863:Hydrogen-Ion Concentration; D007201:Indicator Dilution Techniques; D008168:Lung / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D009330:Nebulizers and Vaporizers; D011312:Pressure; D011651:Pulmonary Artery / Q000502:physiology; D011654:Pulmonary Edema / Q000139:chemically induced*; D011669:Pulmonary Wedge Pressure; D012906:Smoke / Q000009:adverse effects*
D000447:Aldehydes; D012906:Smoke; D000171:Acrolein; D006851:Hydrochloric Acid