Acute hydrogen sulfide poisoning in a dairy farmer
INTRODUCTION. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who developed acute respiratory arrest from hydrogen sulfide poisoning while performing work as a dairy farmer. The subject entered a poorly ventilat...
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| Published in | Clinical toxicology (Philadelphia, Pa.) Vol. 45; no. 4; pp. 420 - 423 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
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Philadelphia, PA
Taylor & Francis
01.05.2007
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| Abstract | INTRODUCTION. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who developed acute respiratory arrest from hydrogen sulfide poisoning while performing work as a dairy farmer.
The subject entered a poorly ventilated tank containing degrading eggs and, within seconds, collapsed. Coworkers were able to extract him within minutes but he was apneic. He was intubated by emergency medical services and subsequently managed with supportive care in the intensive care unit. Upon admission, a powerful rotten egg scent was noted and a hydrogen sulfide poisoning was suspected. Serum analysis for the presence of thiosulfate confirmed the diagnosis. Nitrite therapy was not administered as the subject arrived outside of the therapeutic window of effectiveness and showed evidence of excellent oxygenation. His examinations following arrival were consistent with an anoxic brain injury which slowly improved several months after the incident with intensive neuro-rehabilitation.
Hydrogen sulfide is a mitochondrial toxin and inhibits cytochrome-aa(3) and prevents cellular aerobic metabolism. Therapies for toxic exposures include removal from the contaminated environment, ventilation with 100% oxygen, and nitrite therapy if administered immediately after exposure. Hyperbaric oxygen (HBO) therapy has anecdotal support and remains controversial.
Hydrogen sulfide is a significant occupational health hazard. Education, personal protective equipment, and early treatment are important in improving outcomes. |
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| AbstractList | INTRODUCTION. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who developed acute respiratory arrest from hydrogen sulfide poisoning while performing work as a dairy farmer.
The subject entered a poorly ventilated tank containing degrading eggs and, within seconds, collapsed. Coworkers were able to extract him within minutes but he was apneic. He was intubated by emergency medical services and subsequently managed with supportive care in the intensive care unit. Upon admission, a powerful rotten egg scent was noted and a hydrogen sulfide poisoning was suspected. Serum analysis for the presence of thiosulfate confirmed the diagnosis. Nitrite therapy was not administered as the subject arrived outside of the therapeutic window of effectiveness and showed evidence of excellent oxygenation. His examinations following arrival were consistent with an anoxic brain injury which slowly improved several months after the incident with intensive neuro-rehabilitation.
Hydrogen sulfide is a mitochondrial toxin and inhibits cytochrome-aa(3) and prevents cellular aerobic metabolism. Therapies for toxic exposures include removal from the contaminated environment, ventilation with 100% oxygen, and nitrite therapy if administered immediately after exposure. Hyperbaric oxygen (HBO) therapy has anecdotal support and remains controversial.
Hydrogen sulfide is a significant occupational health hazard. Education, personal protective equipment, and early treatment are important in improving outcomes. INTRODUCTION. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who developed acute respiratory arrest from hydrogen sulfide poisoning while performing work as a dairy farmer.UNLABELLEDINTRODUCTION. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who developed acute respiratory arrest from hydrogen sulfide poisoning while performing work as a dairy farmer.The subject entered a poorly ventilated tank containing degrading eggs and, within seconds, collapsed. Coworkers were able to extract him within minutes but he was apneic. He was intubated by emergency medical services and subsequently managed with supportive care in the intensive care unit. Upon admission, a powerful rotten egg scent was noted and a hydrogen sulfide poisoning was suspected. Serum analysis for the presence of thiosulfate confirmed the diagnosis. Nitrite therapy was not administered as the subject arrived outside of the therapeutic window of effectiveness and showed evidence of excellent oxygenation. His examinations following arrival were consistent with an anoxic brain injury which slowly improved several months after the incident with intensive neuro-rehabilitation.CASE REPORTThe subject entered a poorly ventilated tank containing degrading eggs and, within seconds, collapsed. Coworkers were able to extract him within minutes but he was apneic. He was intubated by emergency medical services and subsequently managed with supportive care in the intensive care unit. Upon admission, a powerful rotten egg scent was noted and a hydrogen sulfide poisoning was suspected. Serum analysis for the presence of thiosulfate confirmed the diagnosis. Nitrite therapy was not administered as the subject arrived outside of the therapeutic window of effectiveness and showed evidence of excellent oxygenation. His examinations following arrival were consistent with an anoxic brain injury which slowly improved several months after the incident with intensive neuro-rehabilitation.Hydrogen sulfide is a mitochondrial toxin and inhibits cytochrome-aa(3) and prevents cellular aerobic metabolism. Therapies for toxic exposures include removal from the contaminated environment, ventilation with 100% oxygen, and nitrite therapy if administered immediately after exposure. Hyperbaric oxygen (HBO) therapy has anecdotal support and remains controversial.DISCUSSIONHydrogen sulfide is a mitochondrial toxin and inhibits cytochrome-aa(3) and prevents cellular aerobic metabolism. Therapies for toxic exposures include removal from the contaminated environment, ventilation with 100% oxygen, and nitrite therapy if administered immediately after exposure. Hyperbaric oxygen (HBO) therapy has anecdotal support and remains controversial.Hydrogen sulfide is a significant occupational health hazard. Education, personal protective equipment, and early treatment are important in improving outcomes.CONCLUSIONHydrogen sulfide is a significant occupational health hazard. Education, personal protective equipment, and early treatment are important in improving outcomes. Introduction. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who developed acute respiratory arrest from hydrogen sulfide poisoning while performing work as a dairy farmer. Case report. The subject entered a poorly ventilated tank containing degrading eggs and, within seconds, collapsed. Coworkers were able to extract him within minutes but he was apneic. He was intubated by emergency medical services and subsequently managed with supportive care in the intensive care unit. Upon admission, a powerful rotten egg scent was noted and a hydrogen sulfide poisoning was suspected. Serum analysis for the presence of thiosulfate confirmed the diagnosis. Nitrite therapy was not administered as the subject arrived outside of the therapeutic window of effectiveness and showed evidence of excellent oxygenation. His examinations following arrival were consistent with an anoxic brain injury which slowly improved several months after the incident with intensive neuro-rehabilitation. Discussion. Hydrogen sulfide is a mitochondrial toxin and inhibits cytochrome-aa3 and prevents cellular aerobic metabolism. Therapies for toxic exposures include removal from the contaminated environment, ventilation with 100% oxygen, and nitrite therapy if administered immediately after exposure. Hyperbaric oxygen (HBO) therapy has anecdotal support and remains controversial. Conclusion. Hydrogen sulfide is a significant occupational health hazard. Education, personal protective equipment, and early treatment are important in improving outcomes. Introduction. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who developed acute respiratory arrest from hydrogen sulfide poisoning while performing work as a dairy farmer. Case report. The subject entered a poorly ventilated tank containing degrading eggs and, within seconds, collapsed. Coworkers were able to extract him within minutes but he was apneic. He was intubated by emergency medical services and subsequently managed with supportive care in the intensive care unit. Upon admission, a powerful rotten egg scent was noted and a hydrogen sulfide poisoning was suspected. Serum analysis for the presence of thiosulfate confirmed the diagnosis. Nitrite therapy was not administered as the subject arrived outside of the therapeutic window of effectiveness and showed evidence of excellent oxygenation. His examinations following arrival were consistent with an anoxic brain injury which slowly improved several months after the incident with intensive neuro-rehabilitation. Discussion. Hydrogen sulfide is a mitochondrial toxin and inhibits cytochrome-aa sub(3) and prevents cellular aerobic metabolism. Therapies for toxic exposures include removal from the contaminated environment, ventilation with 100% oxygen, and nitrite therapy if administered immediately after exposure. Hyperbaric oxygen (HBO) therapy has anecdotal support and remains controversial. Conclusion. Hydrogen sulfide is a significant occupational health hazard. Education, personal protective equipment, and early treatment are important in improving outcomes. |
| Author | Musser, Jeffrey Gerasimon, Gregg Rinard, John Bennett, Steven |
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| Keywords | Human Toxic gas Cytochrome-aa3 Enzyme Acute Nitrites Cytochrome-c oxidase Hyperbaric oxygen Nitrite Case study Hydrogen sulfide Occupational accident Hyperbaric oxygen (HBO) Treatment Poisoning Oxidoreductases Farmer Occupational medicine |
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| Snippet | INTRODUCTION. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who... Introduction. Hydrogen sulfide is a lipid-soluble gas produced in occupational settings and from decaying organic matter. We present a 36-year-old man who... |
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| SubjectTerms | Acute Disease Adult Agricultural Workers' Diseases - blood Agricultural Workers' Diseases - chemically induced Agricultural Workers' Diseases - rehabilitation Apnea - chemically induced Biological and medical sciences Chemical and industrial products toxicology. Toxic occupational diseases Dairying Eggs Gas, fumes Humans Hydrogen Sulfide - blood Hydrogen Sulfide - poisoning Hypoxia, Brain - chemically induced Hypoxia, Brain - physiopathology Hypoxia, Brain - rehabilitation Male Medical sciences Nervous System Diseases - blood Nervous System Diseases - chemically induced Nervous System Diseases - rehabilitation Occupational Exposure - adverse effects Occupational Exposure - analysis Thiosulfates - blood Toxicology |
| Title | Acute hydrogen sulfide poisoning in a dairy farmer |
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