Abstract
Phosgene has been deployed as a CW and is also widely used in the chemical industry. Following exposure, acute lung injury (ALI) occurs after a latency period of 6 – 12 h, with pulmonary oedema ensuing. Death may occur 6–24 h after exposure. There is no specific therapy.
Conventional ventilation strategies (VS) for the treatment of ALI and ARDS utilise tidal volumes of 10 – 12 ml.Kg−1 with variable PEEP. A recent multinational clinical trial advocates a protective VS (PVS) combining reduced tidal volume and increased PEEP, which resulted in a significant reduction in mortality.
The purpose of this study is to determine if a similar strategy is beneficial in the treatment of PIALI.
Twenty female pigs were anaesthetised and instrumented for the collection of physiological and biochemical data. Following surgery the animals equilibrated for 1 hour, and exposed to air (Control) or Phosgene (10 min). At 30 minutes post exposure, ventilation was initiated and the animals further divided into treatment groups prior to monitoring for up to 24 hours.
Preliminary results show that, utilising a PVS, there is an increase in oxygenation together with reduced mortality at 24 hour post exposure. Post mortem showed a decrease in severity of pathology and lung wet weight/ body weight ratio.
These results would indicate that in a clinical situation this strategy would be of benefit in the treatment of PIALI.
These abstracts were prepared by Squadron Leader G. Pathak FRCS (Trauma & Orth). Correspondence should be addressed to him at Royal Hospital Haslar, Gosport, Hampshire PO12 2AA.
