[Ammonia-gas poisoning: respiratory troubles evaluated by functional exploration]

The objective of our research is first to evaluate the defects in the respiratory function which have been noticed among patients suffering from ammonia poisoning during the accident at the SONACOS factory of Dakar in 1992. Secondly it is to set precisely the seriousness of the problem. This retrospective study is carried out on 50 patients examined at the Physiology and Functional Exploration Laboratory of the faculty of Medicine of Dakar University from March 1993 to October 1995. These patients have been submitted to at least two respiratory functional explorations. Ten of them have been treated for two years, thus benefiting from a spirographic control of these respiratory troubles already noticed. 58 % of the patients have developed an obstruction syndrome with the following specifities : fourteen patients out of 29 revealed a serious stoppage of the bronchi, twelve had a moderate bronchial obstruction, and three showed a minor bronchial obstruction. Besides, 34 % of the patients have developed a mixed syndrome with a minor restrictive component and a severe obstructive component. 8 % of the poisoned have presented a normal lung function testing. About the localisation of the respiration disorders at the level of the bronchial system, 61 % of the patients have shown an obstruction of the proximal, medial and distal bronchi. 26 % have presented obstruction of the distal bronchi, 13 % have shown an attack at their medial and distal bronchi. 5 patients out of 10 have shown any modification in their respiratory troubles while 3 of 10 have shown significant improvement. Then 2 out of 10 have shown degradation in their respiratory problems with an extension of bronchial obstruction. The ammonia poisoning has caused serious respiratory disorders related to the general and local toxic action of ammonia on the respiratory tract, its retention at their level and its effects on the respiratory function. The severity of the patent injuries incites to issue recommendations concerning the prevention of ammonia poisoning and the quick and efficient taking charge of the casualties in case of any accidental intoxication.