Tuberculosis and Respiratory Diseases

  • 제72권2호
  • /
  • Pages.177-181
  • /
  • 2012
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지
DOI QR코드

DOI QR Code

기관지내시경을 통해 치료한 활성탄 흡인 1예

A Case of Activated Charcoal Aspiration Treated by Early and Repeated Bronchoalveolar Lavage

  • 이한민 (순천향대학교 천안병원 내과) ;
  • 박재석 (순천향대학교 천안병원 내과) ;
  • 김재연 (순천향대학교 천안병원 내과) ;
  • 이지연 (순천향대학교 서울병원 내과) ;
  • 안병규 (순천향대학교 서울병원 내과) ;
  • 길효욱 (순천향대학교 천안병원 내과) ;
  • 최재성 (순천향대학교 천안병원 내과)
  • Lee, Han-Min (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Park, Jae-Seok (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Kim, Jae-Yun (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Lee, Ji-Yeon (Department of Internal Medicine, Soonchunhyang University Seoul Hospital) ;
  • Ahn, Byung-Kyu (Department of Internal Medicine, Soonchunhyang University Seoul Hospital) ;
  • Gil, Hyo-Wook (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Choi, Jae-Sung (Department of Internal Medicine, Soonchunhyang University Cheonan Hospital)
  • 투고 : 2011.09.05
  • 심사 : 2011.10.20
  • 발행 : 2012.02.29
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Activated charcoal is an inert substance and it is used in standard therapy in patients with acute intoxication. Charcoal has some side effects such as pulmonary aspiration, gastrointestinal complications, and electrolyte abnormalities. Although aspiration of charcoal is a rare complication, it can cause fatal sequelae. We report a 69-year old man who developed acute respiratory failure associated with charcoal aspiration after management of glyphosate poisoning. The patient was drowsy and suffered severe vomiting during transport to our hospital. On arrival, acute respiratory failure was observed due to charcoal aspiration, but the clinical state was improved with repeated bronchoscopy with a bronchoalveolar lavage (BAL). We presumed that the aspirated charcoal was an important factor in evoking a lung injury. Early bronchoscopy with a BAL might be an effective method for eliminating charcoal from the lung, especially in the case of a large amount of aspiration, and be helpful in decreasing respiratory failure due to charcoal aspiration.

키워드

참고문헌

  1. Francis RC, Schefold JC, Bercker S, Temmesfeld- Wollbrück B, Weichert W, Spies CD, et al. Acute respiratory failure after aspiration of activated charcoal with recurrent deposition and release from an intrapulmonary cavern. Intensive Care Med 2009;35:360-3. https://doi.org/10.1007/s00134-008-1259-5
  2. Position statement and practice guidelines on the use of multi-dose activated charcoal in the treatment of acute poisoning. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 1999;37:731-51. https://doi.org/10.1081/CLT-100102451
  3. Elliott CG, Colby TV, Kelly TM, Hicks HG. Charcoal lung. Bronchiolitis obliterans after aspiration of activated charcoal. Chest 1989;96:672-4. https://doi.org/10.1378/chest.96.3.672
  4. Knaus WA, Draper EA, Wagner DP, Zimmerman JE.APACHE II: a severity of disease classification system. Crit Care Med 1985;13:818-29. https://doi.org/10.1097/00003246-198510000-00009
  5. Nam HS, Park MR, Park SY, Lim SY, Kim SA, Song JU, et al. A preliminary study on the effect of "low-dose" glucocorticoid therapy for patients with persistent acute respiratory distress syndrome. Korean J Crit Care Med 2009;24:80-6. https://doi.org/10.4266/kjccm.2009.24.2.80
  6. Huber M, Pohl W, Reinisch G, Attems J, Pescosta S, Lintner F. Lung disease 35 years after aspiration of activated charcoal in combination with pulmonary lymphangioleiomyomatosis. A histological and clinicopathological study with scanning electron microscopic evaluation and element analysis. Virchows Arch 2006;449: 225-9. https://doi.org/10.1007/s00428-006-0236-z
  7. Seder DB, Christman RA, Quinn MO, Knauft ME. A 45-year-old man with a lung mass and history of charcoal aspiration. Respir Care 2006;51:1251-4.
  8. Kim S, Kang NR, Sohn I, Lee H, Lee YK, Song SH. Acute respiratory distress syndrome with chemical pneumonitis after aspiration of activated charcoal: a case report. Korean J Crit Care Med 2010;25:112-7. https://doi.org/10.4266/kjccm.2010.25.2.112
  9. Roberts DM, Buckley NA, Mohamed F, Eddleston M, Goldstein DA, Mehrsheikh A, et al. A prospective observational study of the clinical toxicology of glyphosate-containing herbicides in adults with acute self-poisoning. Clin Toxicol (Phila) 2010;48:129-36. https://doi.org/10.3109/15563650903476491
  10. Harris CR, Filandrinos D. Accidental administration of activated charcoal into the lung: aspiration by proxy. Ann Emerg Med 1993;22:1470-3. https://doi.org/10.1016/S0196-0644(05)81998-5
  11. Golej J, Boigner H, Burda G, Hermon M, Trittenwein G. Severe respiratory failure following charcoal application in a toddler. Resuscitation 2001;49:315-8. https://doi.org/10.1016/S0300-9572(00)00362-2