Management and sequelae of a 41-year-old jehovah's witness with severe anhydrous ammonia inhalation injury.
Anhydrous ammonia is a commonly used chemicals that are found in fertilizer, refrigeration, and in other occupational environments. Lung damage because of inhalation of ammonia can be devastating, producing debilitating lung disease and can ultimately lead to death. This is the case of a 41-year-old male, previously healthy, Jehovah's Witness, who was working at a poultry plant facility when an explosion occurred exposing him to toxic levels of anhydrous ammonia. Our patient developed end-stage lung disease after sustaining a severe ammonia inhalation injury. Despite aggressive pulmonary rehabilitation, the patient continued to deteriorate, and his only option for a chance at improved quality of life was a double-lung transplant. To our knowledge, this is the first report of a bloodless lung transplantation for inhalational lung injury in the literature. Further study is needed to better understand the effects of ammonia on lung physiology in order to better manage and treat patients who develop acute and chronic lung complications after exposure.
From the *Departments of Surgery and †Respiratory Care, ‖Division of Pulmonary Diseases and Critical Care Medicine, Department of Medicine, University of North Carolina at Chapel Hill; and ‡Division of Pulmonary, Allergy, and Critical Care Medicine, §Division of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pennsylvania.
Shiara
S
Ortiz-Pujols
Samuel W
SW
Jones
Kathy A
KA
Short
Matthew R
MR
Morrell
Christian A
CA
Bermudez
Stephen L
SL
Tilley
Bruce A
BA
Cairns
D000062:Accidents, Occupational; D000328:Adult; D000383:Agriculture; D064753:Ammonium Hydroxide / Q000633:toxicity*; D002059:Burns, Inhalation / Q000150:complications* / Q000209:etiology / Q000503:physiopathology; D018450:Disease Progression; D005107:Explosions; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D033221:Jehovah's Witnesses; D055370:Lung Injury / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D016040:Lung Transplantation / Q000379:methods; D008297:Male; D011788:Quality of Life; D035583:Rare Diseases; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
D064753:Ammonium Hydroxide