title: R-134a (1,1,1,2-Tetrafluoroethane) Inhalation Induced Reactive Airways Dysfunction Syndrome.
abstract: R-134a (1,1,1,2-tetrafluoroethane) is widely used as a refrigerant and as an aerosol propellant. Inhalation of R-134a can lead to asphyxia, transient confusion, and cardiac arrhythmias. We report a case of reactive airways dysfunction syndrome secondary to R-134a inhalation. A 60-year-old nonsmoking man without a history of lung disease was exposed to an air conditioner refrigerant spill while performing repairs beneath a school bus. Afterward, he experienced worsening shortness of breath with minimal exertion, a productive cough, and wheezing. He was also hypoxic. He was admitted to the hospital for further evaluation. Spirometry showed airflow obstruction with an FEV1 1.97 L (45% predicted). His respiratory status improved with bronchodilators and oral steroids. A repeat spirometry 2 weeks later showed improvement with an FEV1 2.5 L (60% predicted). Six months after the incident, his symptoms had improved, but he was still having shortness of breath on exertion and occasional cough.
authors.affiliation: 1Division of Pulmonary & Critical Care Medicine, Southern Illinois University School of Medicine, Springfield, IL; and 2Division of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL.
authors.forename: Viral
authors.initials: V
authors.lastname: Doshi
authors.forename: Nang
authors.initials: N
authors.lastname: Kham
authors.forename: Shreedhar
authors.initials: S
authors.lastname: Kulkarni
authors.forename: Kent
authors.initials: K
authors.lastname: Kapitan
authors.forename: Joseph
authors.initials: J
authors.lastname: Henkle
authors.forename: Peter
authors.initials: P
authors.lastname: White
mesh_terms: D000335:Aerosol Propellants / Q000009:adverse effects*; D000402:Airway Obstruction / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000627:therapeutic use; D005541:Forced Expiratory Volume; D006801:Humans; D006845:Hydrocarbons, Fluorinated / Q000009:adverse effects*; D019570:Inhalation Exposure / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D013147:Spirometry; D004980:Ethane / Q000031:analogs & derivatives; D005466:Fluorocarbons
chemical_list: D000335:Aerosol Propellants; D001993:Bronchodilator Agents; D006845:Hydrocarbons, Fluorinated; C063006:norflurane; D004980:Ethane; D005466:Fluorocarbons