Basic research and clinical innovative treatment in patients with sudden mass phosgene poisoning.
10.3760/cma.j.cn121430-20230717-00528
- Author:
Maoxing YUE
1
;
Jie SHEN
2
Author Information
1. Trauma Center, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou 213161, Jiangsu, China.
2. Emergency and Critical Illness Center, Jinshan Hospital Affiliated to Fudan University, Shanghai 201508, China. Corresponding author: Shen Jie, Email: j1999sh@163.com.
- Publication Type:Journal Article
- MeSH:
Humans;
Phosgene;
Chemical Warfare Agents;
Acute Lung Injury/drug therapy*;
Respiratory Distress Syndrome/therapy*;
Treatment Outcome
- From:
Chinese Critical Care Medicine
2023;35(12):1233-1240
- CountryChina
- Language:Chinese
-
Abstract:
Phosgene is not only a dangerous asphyxiating chemical warfare agent, but also an important chemical raw material, which is widely used in chemical production. According to statistics, there are more than 1 000 phosgene production enterprises in China, with an annual production volume of more than 3 million tons and hundreds of thousands of employees. Therefore, once the leakage accident occurs during production, storage and transportation, it often causes a large number of casualties. In the past 20 years, phosgene poisoning accidents in China have occurred from time to time, and due to the weak irritation, high density, and high concentration of phosgene at the scene of the accident, it often results in acute high-concentration inhalation of the exposed, triggering acute lung injury (ALI), and is very likely to progress to acute respiratory distress syndrome (ARDS), with a mortality rate up to 40%-50%. In view of the characteristics of sudden, mass, concealed, rapid and highly fatal phosgene, and the mechanism of its toxicity and pathogenicity is still not clear, there is no effective treatment and standardized guidance for the sudden group phosgene poisoning. In order to improve the efficiency of clinical treatment and reduce the mortality, this paper has summarized the pathophysiological mechanism of phosgene poisoning, clinical manifestations, on-site treatment, research progress, and innovative clinical therapies by combining the extensive basic research on phosgene over the years with the abundant experience in the on-site treatment of sudden mass phosgene poisoning. This consensus aims to provide guidance for the clinical rescue and treatment of patients with sudden mass phosgene poisoning, and to improve the level of treatment.
