Low-voltage electricity-induced lung injury

Isolated pulmonary hemorrhage after electric shock: a rare phenomenon

Any type of contact with electricity of low or high voltage can cause injury to the human body, with a variable effect on the body. Low-voltage injury is quite common worldwide, but there is very little information present in the available literature. The degree of organ damage depends on many factors, which include the duration of electric current exposure, current type, and nature of the affected tissue. The most common presentations are muscle injury, hyperkalemia, pulmonary edema, and rarely isolated diffuse pulmonary hemorrhage. We present a case of bilateral pulmonary hemorrhage due to electric shock with no visible signs of damage to the chest wall when exposed to a 220 V shock. The diagnosis was confirmed by fresh hemoptysis, chest imaging that showed bilateral perihilar ground glass opacities, and bronchoscopy findings. Given a life-threatening condition, a timely diagnosis is required, as massive hemoptysis can occlude the airways, leading to hypoxia and mortality.

Noncardiogenic pulmonary edema in small animals

OBJECTIVE

To review various types of noncardiogenic pulmonary edema (NCPE) in cats and dogs.

ETIOLOGY

NCPE is an abnormal fluid accumulation in the lung interstitium or alveoli that is not caused by cardiogenic causes or fluid overload. It can be due to changes in vascular permeability, hydrostatic pressure in the pulmonary vasculature, or a combination thereof. Possible causes include inflammatory states within the lung or in remote tissues (acute respiratory distress syndrome [ARDS]), airway obstruction (post-obstructive pulmonary edema), neurologic disease such as head trauma or seizures (neurogenic pulmonary edema), electrocution, after re-expansion of a collapsed lung or after drowning.

DIAGNOSIS

Diagnosis of NCPE is generally based on history, physical examination, and diagnostic imaging. Radiographic findings suggestive of NCPE are interstitial to alveolar pulmonary opacities in the absence of signs of left-sided congestive heart failure or fluid overload such as cardiomegaly or congested pulmonary veins. Computed tomography and edema fluid analysis may aid in the diagnosis, while some forms of NCPE require additional findings to reach a diagnosis.

THERAPY

The goal of therapy for all types of NCPE is to preserve tissue oxygenation and reduce the work of breathing. This may be achieved by removing the inciting cause (eg, airway obstruction) and cage rest in mild cases and supplemental oxygen in moderate cases and may require mechanical ventilation in severe cases.

PROGNOSIS

Prognosis is generally good for most causes of veterinary NCPE except for ARDS, although data are scarce for some etiologies of NCPE.

Electric shock leading to acute lung injury in a scuba diver

INTRODUCTION

Electrical injuries are a rarely reported complication of scuba diving.

CASE REPORT

A 33-year-old woman wore a 12-volt heated shirt designed for motorcycling, powered by a canister light battery, while scuba diving. A leak in her drysuit allowed water to make contact with an electrified connector from the heated shirt, and she experienced painful electrical shocks. She was able to disconnect the power source and finish the dive, but she developed progressive fevers and dyspnoea several hours later. She was diagnosed with acute lung injury and treated with bronchodilators. Her symptoms resolved over subsequent weeks.

DISCUSSION

Acute lung injury is rarely reported after low voltage electrical injury. In this case, the use of a heated shirt that was not intended for underwater activities heightened the patient's risk for electric shock that likely resulted in aspiration of sea water and subsequent acute lung injury. To reduce risk of injury, divers should use equipment that is designed for underwater submersion. Medical professionals who treat the diving population should be aware that divers may use modified equipment that increases the risk of diving-related complications.

Electricity induced burns and lung injury: A rare autopsy observation

Electrocutions injuries are frequently encountered in a domestic setting or as an occupational hazard. Electrocutions injuries sustained in occupational settings are often associated with significant morbidity and mortality globally. Autopsy diagnosis of electrocution is mostly based on gross and histopathological changes in the entry and exit wounds. Gross changes in form of entry and exit wounds, however, may not be present in all cases of electrocution. In such cases, histopathological changes in the internal organs along the path of current can be useful. We report a case of fatal electrocution involving a 23-year-old young male in which remarkable gross and microscopic changes were appreciated in the lung due to the passage of electric current through it. Such observations are rarely reported in literature and highlight on the significance of autopsy pathology in the diagnosis of electrocution.

A Case Report: Low Voltage Electric Injuries Culminating in Cardiac Arrest and Direct Lung Injury

Serious electrical injuries are rare but may have life-threatening consequences. Voltage exposure injuries are divided into low voltage injury (LVI) or high voltage injury (HVI). An LVI current can result in severe injury, depending on the length of exposure, the size of the individual, the cross-sectional area in contact with the electrical source, and environmental humidity.

The authors present a 31-year-old male with accidental electrocution with low voltage current and cardiopulmonary arrest. A detailed revision by organs and systems is presented.

LVI is uncommon and can occur with a variety of clinical presentations, rarely presenting with direct lung injury. Early recognition and support are the cornerstones of treatment.

Low-voltage electricity-induced lung injury

We report a case of bilateral pulmonary infiltrates and haemoptysis following low-voltage electricity exposure in an agricultural worker. A 58-year-old man standing in water reached for an electric watering machine and sustained an exposure to 220 V circuit for an uncertain duration. The electricity was turned off by another worker, and the patient was asymptomatic for the next 10 h until he developed haemoptysis. A chest radiograph demonstrated bilateral infiltrates, and chest computed tomography (CT) revealed ground-glass opacities with interstitial thickening. Evaluations, including electrocardiogram, serum troponin, N-terminal pro-B-type natriuretic peptide (NT-pro BNP), coagulation studies, and echocardiogram, found no abnormality. The patient was treated for suspected electricity-induced lung injury and bleeding with tranexamic acid and for rhabdomyolysis with volume resuscitation. He recovered with complete resolution of chest radiograph abnormalities by Day 7. This is the first reported case of bilateral lung oedema and/or injury after electricity exposure without cardiac arrest.