Severe respiratory failure following charcoal application in a toddler

Related Experiment Video

Updated: Oct 3, 2026

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Published on: April 7, 2021

J Golej1, H Boigner, G Burda

  • 1Department of Neonatology and Pediatric Intensive Care, University Children's Hospital Vienna, Austria. Johann.Golej@akh-wien.ac.at

Resuscitation
|November 29, 2001
PubMed

Insights

Enteral detoxification with charcoal via gastric tubes in toddlers is generally safe, but aspiration is a rare risk. This case highlights the potential for severe respiratory failure from endobronchial charcoal contamination.

Area of Science:

  • Pediatric critical care medicine
  • Gastroenterology
  • Toxicology

Background:

  • Activated charcoal is frequently used for enteral detoxification in pediatric patients.
  • Gastric tube administration is a common method for delivering charcoal, especially in toddlers.
  • Aspiration of charcoal is considered a rare complication.

Observation:

  • A 19-month-old boy experienced endobronchial charcoal contamination after gastric tube administration.
  • This led to acute airway obstruction and severe respiratory failure, despite standard tube placement verification.
  • Initial chest X-rays did not accurately represent the extent of endobronchial charcoal deposition.

Findings:

  • The patient required immediate intubation, tracheal suctioning, bronchodilators, and high-frequency oscillatory ventilation (HFOV) to manage hypoxia and hypercarbia.
  • Successful removal of charcoal was achieved through bronchoscopy.
  • Gastric tube administration of charcoal in children poses a significant risk of aspiration.

Implications:

  • Pediatric patients receiving charcoal via gastric tubes are at risk for life-threatening respiratory complications.
  • Prompt medical intervention, including artificial ventilation and bronchial lavage, may be necessary.
  • Standard tube verification techniques may not always prevent aspiration events.

More Related Videos

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device09:36

Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device

Published on: September 24, 2020

Related Concept Videos

Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Pulmonary Cycle: Exhalation01:17

Pulmonary Cycle: Exhalation

In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...