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Truicu FN, Damian RO, Butoi MA, Belghiru VI, Rotaru LT, Puticiu M, Văruț RM. How to Personalize General Anesthesia-A Prospective Theoretical Approach to Conformational Changes of Halogenated Anesthetics in Fire Smoke Poisoning. Int J Mol Sci 2024; 25:4701. [PMID: 38731919 PMCID: PMC11083261 DOI: 10.3390/ijms25094701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Revised: 04/21/2024] [Accepted: 04/22/2024] [Indexed: 05/13/2024] Open
Abstract
Smoke intoxication is a central event in mass burn incidents, and toxic smoke acts at different levels of the body, blocking breathing and oxygenation. The majority of these patients require early induction of anesthesia to preserve vital functions. We studied the influence of hemoglobin (HMG) and myoglobin (MGB) blockade by hydrochloric acid (HCl) in an interaction model with gaseous anesthetics using molecular docking techniques. In the next part of the study, molecular dynamics (MD) simulations were performed on the top-scoring ligand-receptor complexes to investigate the stability of the ligand-receptor complexes and the interactions between ligands and receptors in more detail. Through docking analysis, we observed that hemoglobin creates more stable complexes with anesthetic gases than myoglobin. Intoxication with gaseous hydrochloric acid produces conformational and binding energy changes of anesthetic gases to the substrate (both the pathway and the binding site), the most significant being recorded in the case of desflurane and sevoflurane, while for halothane and isoflurane, they remain unchanged. According to our theoretical model, the selection of anesthetic agents for patients affected by fire smoke containing hydrochloric acid is critical to ensure optimal anesthetic effects. In this regard, our model suggests that halothane and isoflurane are the most suitable choices for predicting the anesthetic effects in such patients when compared to sevoflurane and desflurane.
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Affiliation(s)
- Flavius Nicușor Truicu
- Emergency Medicine and First Aid Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.N.T.); (R.O.D.); (M.A.B.); (V.I.B.)
| | - Roni Octavian Damian
- Emergency Medicine and First Aid Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.N.T.); (R.O.D.); (M.A.B.); (V.I.B.)
| | - Mihai Alexandru Butoi
- Emergency Medicine and First Aid Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.N.T.); (R.O.D.); (M.A.B.); (V.I.B.)
| | - Vlad Ionuț Belghiru
- Emergency Medicine and First Aid Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.N.T.); (R.O.D.); (M.A.B.); (V.I.B.)
| | - Luciana Teodora Rotaru
- Emergency Medicine and First Aid Department, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (F.N.T.); (R.O.D.); (M.A.B.); (V.I.B.)
| | - Monica Puticiu
- Emergency Medicine and First Aid Department, Faculty of Medicine, University of Medicine and Pharmacy “Vasile Goldiș” Arad, 310025 Arad, Romania
| | - Renata Maria Văruț
- Research Methodology Department, Faculty of Pharmacy, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
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Liu Z, Meng H, Huang J, Kwangwari P, Ma K, Xiao B, Li L. Acute carbon monoxide poisoning with low saturation of carboxyhaemoglobin: a forensic retrospective study in Shanghai, China. Sci Rep 2021; 11:18554. [PMID: 34535720 PMCID: PMC8448847 DOI: 10.1038/s41598-021-97436-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
Carbon monoxide (CO) poisoning is a common cause of death, leading to morbidity and mortality worldwide. Features of the CO poisoning with low carboxyhemoglobin (COHb) levels remain to be characterized. This study collected a total of 307 CO poisoning cases from Shanghai Public Security Bureau, an official organization that handles the most complicated and life-threatening cases across Shanghai municipality in China, and regrouped these cases into three categories: group 1, 10% < COHb% < 30% (n = 58); group 2, 30% ≤ COHb% < 50% (n = 79); group 3, COHb% ≥ 50% (n = 170). Epidemiological, demographic, and forensic aspects of the CO poisoning cases, particularly those with low COHb levels, were analyzed. Our results showed that group 2 and 3 were mostly observed in younger victims (≤ 30 years), while group 1 equally distributed to all age groups (p = 0.03). All the CO poisoning from group 2 and 3 occurred in enclosed spaces, whereas cases from group 1 died additionally in outdoor spaces (p = 0.01). 81.03% of group 1 cases died in fire circumstances, while only 45.57% from group 2 and 30.59% from group 3 were fire-related (p = 0.00). Accordingly, group 1 was mostly related with fire burns, while group 2 or 3 were largely associated with gas leakage (p = 0.00). A combination with alcohol, but not other psychotropic drugs, associated with significant higher levels of blood COHb% in fire-unrelated (p = 0.021) but not fire-related cases (p = 0.23). Five extremely low COHb% (< 30%)-related poisoning deaths were negative of any cardiopulmonary pathology and psychoactive substances. In conclusion, CO poisoning with low COHb% significantly associates with fire circumstances and outdoor spaces and has no age preference. Further diagnostic markers mandates to be identified in order to avoid disputes in cases of extremely low COHb%-related poisoning.
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Affiliation(s)
- Zheng Liu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, China
| | - Hang Meng
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Public Security Bureau, 803 North Zhongshan Road, Hongkou District, Shanghai, 200083, China
| | - Juntian Huang
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, China
| | - Pascal Kwangwari
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, China
| | - Kaijun Ma
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Public Security Bureau, 803 North Zhongshan Road, Hongkou District, Shanghai, 200083, China
| | - Bi Xiao
- Shanghai Key Laboratory of Crime Scene Evidence, Shanghai Public Security Bureau, 803 North Zhongshan Road, Hongkou District, Shanghai, 200083, China.
| | - Liliang Li
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, China.
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Tang JA, Amadio G, Nagappan L, Schmalbach CE, Dion GR. Laryngeal inhalational injuries: A systematic review. Burns 2021; 48:23-33. [PMID: 33814215 DOI: 10.1016/j.burns.2021.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/19/2020] [Accepted: 02/05/2021] [Indexed: 02/07/2023]
Abstract
Laryngeal inhalation injury carries a significant increase in mortality rate and often indicates immediate airway evaluation. This may be difficult in the setting of clinical deterioration necessitating immediate intubation, which itself can synergistically cause mucosal damage. Prior studies do not encompass predictive factors or long-term outcomes for the laryngotracheal complex. This systemic review of PubMed, Embase, and Cochrane identified studies investigating inhalational injuries of the upper airway. Demographic data as well as presentation, physical findings, and delayed sequelae were documented. Laryngotracheal burn patients were divided into two cohorts based on timing of laryngeal injury diagnosis (before- versus after-airway intervention). 1051 papers met initial search criteria and 43 studies were ultimately included. Airway stenosis was more common in patients that were intubated immediately (50.0%, n = 18 versus 5.2%, n = 13; p = 0.57). Posterior glottic involvement was only identified in patients intubated prior to airway evaluation (71.4%, n = 15). All studies reported a closed space setting for those patients in whom airway intervention preceded laryngeal evaluation. Laryngeal inhalational injuries are a distinct subset that can have a variety of minor to severe laryngotracheal delayed sequelae, particularly for thermal injuries occurring within enclosed spaces. Given these findings, early otolaryngology referral may mitigate or treat these effects.
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Affiliation(s)
- Jessica A Tang
- Department of Otolaryngology, Head and Neck Surgery, Temple University Hospital, Philadelphia, PA, USA
| | - Grace Amadio
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Lavanya Nagappan
- Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Cecelia E Schmalbach
- Department of Otolaryngology, Head and Neck Surgery, Temple University Hospital, Philadelphia, PA, USA; Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA; Temple Head and Neck Institute, Philadelphia, PA, USA
| | - Gregory R Dion
- US Army Institute of Surgical Research, Joint Base San Antonio, Fort Sam Houston, TX, USA.
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Tripathi K, Kanchwala N, Mohan RR, Baranwal S, Jha M, Bhattacharya S. Role of fibreoptic bronchoscopy in early diagnosis of inhalational burns in patients with facial burns. INDIAN JOURNAL OF BURNS 2021. [DOI: 10.4103/ijb.ijb_6_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Thermo-Fluid Dynamics Analysis of Fire Smoke Dispersion and Control Strategy in Buildings. ENERGIES 2020. [DOI: 10.3390/en13226000] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Smoke is the main threat of death in fires. For this reason, it becomes extremely important to understand the dispersion of this pollutant and to verify the influence of different control systems on its spread through buildings, in order to avoid or minimize its effects on living beings. Thus, this work aims to perform thermo-fluid dynamic study of smoke dispersion in a closed environment. All numerical analysis was performed using the Fire Dynamics Simulator (FDS) software. Different simulations were carried out to evaluate the influence of the exhaust system (natural or mechanical), the heat release rate (HRR), ventilation and the smoke curtain in the pollutant dispersion. Results of the smoke layer interface height, temperature profile, average exhaust volumetric flow rate, pressure and velocity distribution are presented and discussed. The results indicate that an increase in the natural exhaust area increases the smoke layer interface height, only for the well-ventilated compartment (open windows); an increase in the HRR accelerates the downward vertical displacement of the smoke layer and that the 3 m smoke curtain is efficient in exhausting smoke, only in the case of poorly ventilated compartments (i.e., with closed windows).
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Gorgun MF, Zhuo M, Dineley KT, Englander EW. Elevated Neuroglobin Lessens Neuroinflammation and Alleviates Neurobehavioral Deficits Induced by Acute Inhalation of Combustion Smoke in the Mouse. Neurochem Res 2019; 44:2170-2181. [PMID: 31420834 DOI: 10.1007/s11064-019-02856-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/03/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022]
Abstract
Acute inhalation of combustion smoke produces long-term neurologic deficits in survivors. To study the mechanisms that contribute to the development of neurologic deficits and identify targets for prevention, we developed a mouse model of acute inhalation of combustion smoke, which supports longitudinal investigation of mechanisms that underlie the smoke induced inimical sequelae in the brain. Using a transgenic mouse engineered to overexpress neuroglobin, a neuroprotective oxygen-binding globin protein, we previously demonstrated that elevated neuroglobin preserves mitochondrial respiration and attenuates formation of oxidative DNA damage in the mouse brain after smoke exposure. In the current study, we show that elevated neuronal neuroglobin attenuates the persistent inflammatory changes induced by smoke exposure in the mouse brain and mitigates concordant smoke-induced long-term neurobehavioral deficits. Specifically, we found that increases in hippocampal density of GFAP and Iba-1 positive cells that are detected post-smoke in wild-type mice are absent in the neuroglobin overexpressing transgenic (Ngb-tg) mice. Similarly, the smoke induced hippocampal myelin depletion is not observed in the Ngb-tg mice. Importantly, elevated neuroglobin alleviates behavioral and memory deficits that develop after acute smoke inhalation in the wild-type mice. Taken together, our findings suggest that the protective effects exerted by neuroglobin in the brains of smoke exposed mice afford protection from long-term neurologic sequelae of acute inhalation of combustion smoke. Our transgenic mouse provides a tool for assessing the potential of elevated neuroglobin as possible strategy for management of smoke inhalation injury.
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Affiliation(s)
- Murat F Gorgun
- Department of Surgery, Medical Branch, University of Texas, 301 University Boulevard, Galveston, TX, 77555, USA
| | - Ming Zhuo
- Department of Surgery, Medical Branch, University of Texas, 301 University Boulevard, Galveston, TX, 77555, USA
| | - Kelly T Dineley
- Department of Neurology, University of Texas Medical Branch, Galveston, TX, USA
- Mitchell Center for Neurodegenerative Diseases, University of Texas Medical Branch, Galveston, TX, USA
- Center for Addiction Research, University of Texas Medical Branch, Galveston, TX, USA
| | - Ella W Englander
- Department of Surgery, Medical Branch, University of Texas, 301 University Boulevard, Galveston, TX, 77555, USA.
- Shriners Hospitals for Children, Galveston, TX, USA.
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Anoxia-Hypoxia in Forensic Neuropsychological Assessment: Cognitive Impact of Pulmonary Injuries, Respiratory Distress, Cerebral Blood Hypoperfusion, and Major Surgeries. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9319-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Cui P, Xin H, Yao Y, Xiao S, Zhu F, Gong Z, Tang Z, Zhan Q, Qin W, Lai Y, Li X, Tong Y, Xia Z. Human amnion-derived mesenchymal stem cells alleviate lung injury induced by white smoke inhalation in rats. Stem Cell Res Ther 2018; 9:101. [PMID: 29650044 PMCID: PMC5898065 DOI: 10.1186/s13287-018-0856-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/17/2018] [Accepted: 03/26/2018] [Indexed: 02/08/2023] Open
Abstract
Background White smoke inhalation (WSI) is an uncommon but potentially deadly cause of acute lung injury and acute respiratory distress syndrome for which no effective pharmaceutical treatment has been developed. This study aimed to determine the protective effects of human amnion-derived mesenchymal stem cells (hAMSCs) against WSI-induced lung injury in rats. Methods hAMSCs were injected into rats via the tail vein 4 h after WSI. At 1, 3, 7, 14, and 28 days after cell injection, hAMSCs labeled with PKH26 in lung, heart, liver, and kidney tissues were observed by fluorescence microscopy. The lung injury score was determined by hematoxylin and eosin staining. Lung fibrosis was assessed by Masson’s trichrome staining. The computed tomography (CT) score was assessed by CT scanning. The wet/dry weight ratio was calculated. The levels of interleukin (IL)-1β, IL-6, and IL-10 were determined by enzyme-linked immunosorbent assays. The expression of surfactant protein (SP)-A, SP-C, and SP-D was measured by Western blotting. Results The injected hAMSCs were primarily distributed in the lung tissues in WSI-induced rats. Compared with the model and phosphate-buffered saline (PBS) group, hAMSC treatment led to reduced lung injury, lung fibrosis, CT score, and inflammation levels in WSI-induced mice. hAMSC treatment also resulted in increased cell retention in the lung, partial pressure of oxygen (PaO2), and PaO2/fraction of inspired oxygen (FiO2) levels, and pulmonary SP-A, SP-C, and SP-D expression compared with that in the model and PBS group. Conclusions hAMSCs are a potential cell-based therapy for WSI-induced lung injury.
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Affiliation(s)
- Pei Cui
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Haiming Xin
- Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Yongming Yao
- Trauma Research Center, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, 100048, People's Republic of China
| | - Shichu Xiao
- Department of Burn surgery, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, China
| | - Feng Zhu
- Department of Burn surgery, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, China
| | - Zhenyu Gong
- Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Zhiping Tang
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Qiu Zhan
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Wei Qin
- Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Yanhua Lai
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Xiaohui Li
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China
| | - Yalin Tong
- Research Laboratory of Burns and Trauma, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China. .,Department of Burns, Plastic and Wound repair surgery, the 181st Hospital of Chinese PLA, Guilin, 541002, People's Republic of China.
| | - Zhaofan Xia
- Department of Burn surgery, Changhai Hospital, Naval Military Medical University, Shanghai, 200433, China.
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Rużycka M, Giebułtowicz J, Fudalej M, Krajewski P, Wroczyński P. Application of 2-Aminothiazoline-4-carboxylic Acid as a Forensic Marker of Cyanide Exposure. Chem Res Toxicol 2017; 30:516-523. [DOI: 10.1021/acs.chemrestox.6b00219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Monika Rużycka
- Bioanalysis
and Drugs Analysis Department, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha Street, 02-097 Warsaw, Poland
| | - Joanna Giebułtowicz
- Bioanalysis
and Drugs Analysis Department, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha Street, 02-097 Warsaw, Poland
| | - Marcin Fudalej
- Forensic
Medicine Department, Medical University of Warsaw, 1 Oczki Street, 02-007 Warsaw, Poland
| | - Paweł Krajewski
- Forensic
Medicine Department, Medical University of Warsaw, 1 Oczki Street, 02-007 Warsaw, Poland
| | - Piotr Wroczyński
- Bioanalysis
and Drugs Analysis Department, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha Street, 02-097 Warsaw, Poland
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Orange-Pigmented Sputum as a Manifestation of Smoke Grenade Inhalation Injury. J Bronchology Interv Pulmonol 2016; 23:76-8. [PMID: 26705018 DOI: 10.1097/lbr.0000000000000191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 34-year-old man presented with scanty hemoptysis, orange-colored expectoration, and mild dyspnea. He was in an enclosed building taking part in a military training exercise inhaling an orange-colored smoke from a smoke grenade ignition. His symptoms developed immediately after the initial exposure but he sought medical assistance 20 hours later because of their persistence. Fiberoptic bronchoscopy was performed revealing diffuse inflammatory tracheobronchial tree with streaky orange-pigmented secretions in the trachea and both main-stem bronchi. Acute tracheobronchitis was diagnosed and the patient was treated with nebulized bronchodilators and intravenous corticosteroids showing complete recovery. To our knowledge, this is the first well-documented report of inhalation injury induced by a smoke bomb explosion including potassium chlorate oxidizer and Sudan I and presenting with orange-pigmented sputum production. Smoke inhalation injury is associated with significant morbidity and mortality. The heterogeneity of the smoke and the large variety of the resulting symptoms may be the reason why a definition, specific diagnostic criteria, and therapeutic guidelines are still lacking.
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Bassi E, Miranda LC, Tierno PFGMM, Ferreira CB, Cadamuro FM, Figueiredo VR, Damasceno MCDT, Malbouisson LMS. Assistance of inhalation injury victims caused by fire in confined spaces: what we learned from the tragedy at Santa Maria. Rev Bras Ter Intensiva 2016; 26:421-9. [PMID: 25607274 PMCID: PMC4304473 DOI: 10.5935/0103-507x.20140065] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 10/28/2014] [Indexed: 11/30/2022] Open
Abstract
On January 2013, a disaster at Santa Maria (RS) due to a fire in a confined space
caused 242 deaths, most of them by inhalation injury. On November 2013, four
individuals required intensive care following smoke inhalation from a fire at the
Memorial da América Latina in São Paulo (SP). The
present article reports the clinical progression and management of disaster victims
presenting with inhalation injury. Patients ERL and OC exhibited early respiratory
failure, bronchial aspiration of carbonaceous material, and carbon monoxide
poisoning. Ventilation support was performed with 100% oxygen, the aspirated material
was removed by bronchoscopy, and cyanide poisoning was empirically treated with
sodium nitrite and sodium thiosulfate. Patient RP initially exhibited cough and
retrosternal burning and subsequently progressed to respiratory failure due to upper
airway swelling and early-onset pulmonary infection, which were treated with
protective ventilation and antimicrobial agents. This patient was extubated following
improvement of edema on bronchoscopy. Patient MA, an asthmatic, exhibited carbon
monoxide poisoning and bronchospasm and was treated with normobaric hyperoxia,
bronchodilators, and corticosteroids. The length of stay in the intensive care unit
varied from four to 10 days, and all four patients exhibited satisfactory functional
recovery. To conclude, inhalation injury has a preponderant role in fires in confined
spaces. Invasive ventilation should not be delayed in cases with significant airway
swelling. Hyperoxia should be induced early as a therapeutic means against carbon
monoxide poisoning, in addition to empiric pharmacological treatment in suspected
cases of cyanide poisoning.
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Affiliation(s)
- Estevão Bassi
- Unidade de Terapia Intensiva de Emergência Cirúrgica e Trauma, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Leandro Costa Miranda
- Unidade de Terapia Intensiva de Emergência Cirúrgica e Trauma, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | - César Biselli Ferreira
- Unidade de Terapia Intensiva de Emergência Cirúrgica e Trauma, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Filipe Matheus Cadamuro
- Unidade de Terapia Intensiva de Emergência Cirúrgica e Trauma, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Viviane Rossi Figueiredo
- Departamento de Broncoscopia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | - Luiz Marcelo Sá Malbouisson
- Unidade de Terapia Intensiva de Emergência Cirúrgica e Trauma, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
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Albuquerque IMD, Trevisan ME, Pasqualoto AS, Prado ALC, Pereira MB, Badaró AFV. Physical therapy performance in the rehabilitation of survivors of the Kiss nightclub tragedy: an experience report. FISIOTERAPIA EM MOVIMENTO 2015. [DOI: 10.1590/0103-5150.028.004.ao01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction : As a result of a fire in the Kiss nightclub that occurred in the city of Santa Maria - RS, 242 people were killed, of whom 235 died on the day of the episode, asphyxiated by the inhalation of toxic smoke. Approximately 1,000 more were injured. Objective : To report the experience of a group of physical therapists, professors at the Federal University of Santa Maria (UFSM), in the rehabilitation of survivors of the fire, victims of burns and inhalation injury. Materials and methods : Quantitative and qualitative study, in which an evaluation protocol of physical functional ability was designed to identify rehabilitation needs. Results : Two hundred seventy patients (147 men, mean age 26.72 ± 9.5 years) were examined, of which approximately 70% had some type of clinical modification or functional impairment that indicated the need for rehabilitation. The most prevalent respiratory signs and symptoms were: dry or productive cough (59.2%); abnormal respiratory pace (11.4%); fatigue (35.92%); dyspnea (17.7%); and chest pain (16.6%). Neurological symptoms such as persistent headache (88.51%), memory loss (11.4%), and paresthesia (8.1%) were also reported. Musculoskeletal injuries (14.7%) and extensive burns (8.8%) were also observed. One hundred and eighty-nine patients were referred to outpatient physical therapy and, of these, 22 still remain at the Outpatient Physical Therapy Unit of the University Hospital of (HUSM). Conclusions : Despite the vast professional experience of this group of physical therapists, the situations experienced were unique and unprecedented, both professionally and personally, and reinforced the importance of joining forces within an emergency care unit, as well as the importance of comprehensive and multi-professional outpatient monitoring.
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Role of fiberoptic bronchoscopy in management of smoke inhalation lung injury. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2015. [DOI: 10.1016/j.ejcdt.2015.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tyagi R, Ramasethu R, Mohanty CS, Singhal A. Two cases of Acute Lung Injury following closed space smoke inhalation. Med J Armed Forces India 2015; 71:S538-41. [PMID: 26858490 DOI: 10.1016/j.mjafi.2015.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/08/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Rahul Tyagi
- Graded Specialist (Pulmonary Medicine), INHS Asvini, Colaba, Mumbai, India
| | - R Ramasethu
- Consultant and Head of Department (Medicine and Nephrology), INHS Asvini, Colaba, Mumbai, India
| | - C S Mohanty
- Classified Specialist (Marine Medicine), INHS Asvini, Colaba, Mumbai, India
| | - Anuj Singhal
- Classified Specialist (Medicine), INHS Asvini, Colaba, Mumbai, India
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