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Inhalants.

Evan S Schwarz1

  • 1Washington University School of Medicine, 660 South Euclid, Campus Box 8072, St Louis, MO 63110, USA.

Critical Care Clinics
|May 31, 2021
PubMed
Summary
This summary is machine-generated.

Toxic inhalants, including irritants and asphyxiants, can harm the respiratory system. A new lung injury, EVALI, linked to vaping cannabinoids, requires supportive care and possibly steroids.

Keywords:
AsphyxiantsElectronic cigarette or vaping use-associated lung injuryInhalationIrritantsToxicantsVaping

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Area of Science:

  • Environmental Health
  • Toxicology
  • Pulmonology

Background:

  • Toxic inhalants are diverse xenobiotics causing respiratory tract injuries.
  • Inhalants are classified as irritants (affecting upper or lower airways based on solubility) and asphyxiants (simple or chemical).
  • Chemical asphyxiants, like cyanide, impair cellular oxygen utilization, while simple asphyxiants reduce oxygen availability.

Purpose of the Study:

  • To review the mechanisms of injury from toxic inhalants.
  • To discuss the classification and effects of respiratory irritants and asphyxiants.
  • To describe the emerging condition of Electronic Cigarette or Vaping Use-Associated Lung Injury (EVALI).

Main Methods:

  • Literature review of toxic inhalant mechanisms.
  • Classification of respiratory irritants by water solubility.
  • Overview of asphyxiant types and their physiological impact.
  • Description of EVALI presentation and potential treatments.

Main Results:

  • Highly water-soluble inhalants primarily affect the upper respiratory tract.
  • Low water-soluble inhalants penetrate deeper, injuring the lower respiratory tract.
  • Chemical asphyxiants, such as cyanide, present unique toxicological challenges requiring specific antidotes like hydroxocobalamin.
  • EVALI is characterized by respiratory and gastrointestinal symptoms, potentially linked to cannabinoid vaping.

Conclusions:

  • Understanding inhalant properties is crucial for predicting injury patterns.
  • Cyanide poisoning necessitates prompt administration of antidotes.
  • EVALI represents a significant emerging public health concern requiring further investigation and management strategies.
  • Supportive care, potentially including steroids, is the current approach for EVALI treatment.