Inhaled budesonide in experimental chlorine gas lung injury: influence of time interval between injury and treatment

Wang, Jianpu; Zhang, Liming; Walther, Sten

doi:10.1007/s00134-001-1175-4

Cited by 56 publications

(52 citation statements)

References 23 publications

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“…3,9,12 There have been previous studies carried out with various doses and duration on chlorine gas in rats, sheep, porcine and dormice. 4,[13][14][15] We selected rats as the experiment animals in our study, since they met our conditions the best. Most of the recently reported chlorine gas exposures include exposures caused by the inhalation of toxic vapor arising from mixing of hypochlorite-containing household cleaning products with acid products.…”

Section: Resultsmentioning

confidence: 99%

Histopathological Study of Short and Long-Term Pulmonary Effects of Nebulized Sodium Bicarbonate Treatment in Chlorine Gas Exposured Rats

Al¹,

Bozkurt²,

Yıldırım³

et al. 2010

Turkiye Klinikleri J Med Sci

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : So di um hypoch lo ri te (known as ble ach) and hydroch lo ric acid are tra di ti o nally used as cle a ning ma te ri als. Mix tu re of the se two li qu ids yi elds chlo ri ne gas. Chlo ri ne gas ex po su re is a fre qu ent re a son for emer gency con sul ta ti ons. The re is no ac cep ted spe ci fic tre at ment for re duc ti on of the pul mo nary in jury. In our study, we ha ve in ves ti ga ted his to pat ho lo gi cally the ef fect of ne bu lized so di um bi car bo na te, the use of which is al so con tro ver si al in the li te ra tu re, in the tre at ment of pulmo nary in jury ca u sed by chlo ri ne gas in ha la ti on. M Ma at te er ri ia al l a an nd d M Me et t h ho od ds s: : Forty-eight rats we re used. Rats we re ran domly dis tri bu ted in to five gro ups. Rats in Gro up 1 (n= 8) we re kept un tre a ted thro ugho ut the study. Rats in Gro up 2 (n= 8), Gro up 3 (n= 8), Gro up 4 (n= 12), and Gro up 5 (n= 12) we re expo sed to 155 ppm chlo ri ne gas in ha la ti on for five mi nu tes. Rats in Gro up 3 and 5 we re ad di ti o nally gi ven ne bu li zed so di um bi car bo na te fol lo wing chlo ri ne gas in ha la ti on. Rats in Gro up 2 and 3 we re sacri fi ced 30 mi nu tes af ter the chlo ri ne in ha la ti on, and rats in Gro up 4 and 5 we re sac ri fi ced 45 days after the in ha la ti on for his to pat ho lo gi cal exa mi na ti ons. Pul mo nary in jury gra de was determined and the re sults we re com pa red bet we en gro ups. Sta tis ti cal analy sis was performed using the SSPS 13.0 softwa re. R Re e s su ul lt ts s: : His to pat ho lo gi cal exa mi na ti on of the lungs of rats in Gro up 2 and 3 sho wed acu te injury. The re was no in jury in Gro up 1. All of the rats in Gro up 2 had Gra de 1 in jury. In Gro up 3, 50% of rats had Gra de 1 and 50% had Gra de 2 in juries. So me of the rats in Gro up 4 and Gro up 5 sho wed si mi lar in ters ti ti al fib ro sis and al ve o lar emph yse ma to us al te ra ti ons. Gra de 3 in jury was not de ter mined in any gro ups. C Co on nc c l lu u s si i o on n: : We conc lu ded that ne bu li zed so di um bi car bo na te in cre a ses the se verity of pul mo nary in jury in the short-term. It has no ef fects on the in jury in the long-term.K Ke ey y W Wo or rd ds s: : In ha la ti on ex po su re; so di um bi car bo na te Ö ÖZ ZE ET T A Am ma aç ç: : Halk ara sın da ça ma şır su yu ve tuz ru hu ola rak bi li nen sod yum hi pok lo rit ve hid rok lorik asit, ge le nek sel ola rak te miz lik ama cı ile kul la nı lır lar. Bu iki sı vı nın ka rış tı rıl ma sı so nu cu klor gazı or ta ya çı kar. Klor ga zı ze hir len me le ri acil ser vi se sık baş vu ru ne den le rin den bi ri si dir. Bu has ta la rın te da vi sin de ana yak la şım semp to ma tik ve des tek le yi ci te da vi dir. Or ta ya çı kan ak ci ğer ha sa rı nı azaltma ya yö ne lik ka bul gör müş spe si fik bir te da vi yak la şı mı yok tur. Ça lış ma mız da, klor ga zı in ha las yonu ile oluş tu ru lan ak ci ğer ha sa rı nın te da vi sin de, kul la nı mı li te ra tür de ...

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Section: Resultsmentioning

confidence: 99%

Histopathological Study of Short and Long-Term Pulmonary Effects of Nebulized Sodium Bicarbonate Treatment in Chlorine Gas Exposured Rats

Al¹,

Bozkurt²,

Yıldırım³

et al. 2010

Turkiye Klinikleri J Med Sci

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“…His initial symptoms of shortness of breath, coughing, and chest pressure were consistent with RADS and/or ARDS; he developed acute respiratory failure and died from complications on the fourth day of hospitalization. While there are no widely accepted medical treatment guidelines for acute chlorine exposure, mostly due to the rare nature of the occurrence, some studies suggest that inhaled bicarbonate and glucocorticoids, including systemic corticosteroids and inhaled agents such as budesonide, may be beneficial, but these findings are largely anecdotal [Bosse 1994;Wang et al 2002Wang et al , 2005. The initial uncertainty surrounding the chemical involved in the release (arsenic trichloride versus chlorine) could have influenced the treatment decisions made during his care.…”

Section: Discussionmentioning

confidence: 99%

“…Inhaled β-adrenergic agents are also appropriate in those with clinical signs of airway obstruction, such as wheeze or cough [Wang et al 2004]. Studies suggest that inhaled bicarbonate and glucocorticoids, including systemic corticosteroids and inhaled agents such as budesonide, may be beneficial, but these findings are largely anecdotal [Bosse 1994;Wang et al 2002Wang et al , 2005.…”

Section: Chlorine Gas Exposure and Health Effectsmentioning

confidence: 99%

Health hazard evaluation report: evaluation of a chlorine gas release at a metal recycling facility.

2017

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“…65 In a porcine model of lung injury induced by chlorine gas inhalation, budesonide given concurrently with chlorine gas attenuated impairment in lung compliance and oxygenation compared with inhaled saline control. 66 Importantly, concurrent treatment with budesonide was also superior to administration 60 min aft er the exposure, suggesting inhibition of the initial infl ammatory cascade may be more eff ective than therapy aft er the proinjury pathways are activated.…”

Section: Inhaled Corticosteroidsmentioning

confidence: 99%

Preventing ARDS

Beitler

Schoenfeld

Thompson

2014

CHEST

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Advances in critical care practice have led to a substantial decline in the incidence of ARDS over the past several years. Low tidal volume ventilation, timely resuscitation and antimicrobial administration, restrictive transfusion practices, and primary prevention of aspiration and nosocomial pneumonia have likely contributed to this reduction. Despite decades of research, there is no proven pharmacologic treatment of ARDS, and mortality from ARDS remains high.Consequently, recent initiatives have broadened the scope of lung injury research to include targeted prevention of ARDS. Prediction scores have been developed to identify patients at risk for ARDS, and clinical trials testing aspirin and inhaled budesonide/formoterol for ARDS prevention are ongoing. Future trials aimed at preventing ARDS face several key challenges.

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Inhaled budesonide in experimental chlorine gas lung injury: influence of time interval between injury and treatment

Abstract: Treatment with inhaled budesonide immediately or 30 min after chlorine gas lung injury had similar positive effects on symptoms and signs of pulmonary injury, whereas treatment delayed for 60 min was less effective.

Cited by 56 publications

References 23 publications

Histopathological Study of Short and Long-Term Pulmonary Effects of Nebulized Sodium Bicarbonate Treatment in Chlorine Gas Exposured Rats

Histopathological Study of Short and Long-Term Pulmonary Effects of Nebulized Sodium Bicarbonate Treatment in Chlorine Gas Exposured Rats

Health hazard evaluation report: evaluation of a chlorine gas release at a metal recycling facility.

Preventing ARDS

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