Death caused by addictive inhalation of nitrous oxide

Abstract

<jats:p> Intoxications with nitrous oxide have been, and still are, a rarity in forensic medicine. Apart from accidental overdose during hospital procedures, intoxication with this gas is the result of voluntary inhalation. We report the fatal case of a 32-year-old male who died during inhalation of nitrous oxide from whipped dairy cream cans and hint on the role of the internet in creating new behaviors among drug addicts. We rely on the autopsy report from the Department of Forensic Medicine, Pomeranian Medical University in Szczecin, on laboratory tests, and court files. Neither the autopsy nor the toxicologic and histopathologic tests disclosed the exact cause of death. However, circumstances in which the body was discovered were indicative that death resulted from cardiorespiratory failure. The present case is interesting with regard to its rarity, diagnostic difficulties and potential harm from nitrous oxide used by the food industry. </jats:p>

Death from Nitrous Oxide

“…Potocka‐Banas et al. reported a case, where a 32‐year‐old man died during inhalation of nitrous oxide from whipped cream cans using a face mask, thus under circumstances similar to our cases.…”

Discriminative stimulus effects of nitrous oxide in mice

“…N 2 O may appeal to medical professionals because it is short acting, undetectable in drug testing and easily diverted (Seidberg and Sullivan, 2004). Repeated N 2 O use can lead to medical complications including cardiac arrhythmias (Garriott and Petty, 1980), B-12 deficiency myelopathy (Hathout and El- Saden, 2011) and cardiorespiratory failure (Potocka-Banas et al, 2011). Acute use risks include skin irritation and necrosis (Hwang et al, 1996).…”

Inhalants

“…Death can occur from accidental trauma (falling, etc. ), asphyxiation by the bag covering the face, aspiration of the compound or vomit, anoxia, cardiac dysfunction, CNS depression, severe allergic reaction, or extreme injury to the lungs (Adgey et al, 1995;Bowen, 2011;Bowen et al, 1999a,b;Garriott and Petty, 1980;Garriott, 1992;Hahn et al, 2006;Kringsholm, 1980;Maxwell, 2001;Novosel et al, 2011;Potocka-Banas et al, 2011). Death can also occur because of fire as some canisters are heated to enhance the amount of solvent available which may result in combustion.…”

“…This condition can lead to ascending lower extremity numbness and weakness (Alt et al, 2011;Lin et al, 2011). Although rare, fatal cases of death have also been associated with nitrous oxide inhalation (Potocka-Banas et al, 2011).…”