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Potentially life-threatening emergency
Hydrocarbon aspiration
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Hydrocarbon aspiration

Contributors: Amirah Khan MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Hydrocarbon aspiration is a rare cause of respiratory failure and death due to accidental ingestion. It is most common in children under the age of 6. This is also seen in adolescents who huff or inhale these products. Rarely, it may be seen in an adult in the setting of occupational exposure.

Hydrocarbon-containing products include petroleum distillates, mineral oil, kerosene, gasoline, engine oil, naphtha, lamp oil, turpentine, carbon tetrachloride, lighter fluid, furniture polish, and cosmetics such as baby oil, sunscreen, massage oil, and nail enamel dryer. Aspiration is more common in hydrocarbons with lower viscosity and surface tension such as kerosene, gasoline, turpentine, and furniture polish.

Direct injury to the lungs results in a chemical pneumonitis that can lead to atelectasis, interstitial inflammation, and necrotizing pneumonia and can culminate in respiratory failure. Symptoms include coughing, hypoxia, gagging, choking, and vomiting.

Ingesting hydrocarbons can cause irritation and inflammation of the oropharynx and upper gastrointestinal tract and can lead to nausea and hematemesis, although these effects are usually mild and rarely require treatment.

Either inhalation or ingestion can result in the development of cardiac dysrhythmias such as fatal ventricular arrhythmias ("sudden sniffing deaths" due to sensitization of the myocardium of catecholamines). Hydrocarbons also affect the central nervous system (CNS) by entering the gastrointestinal or pulmonary circulation, leading to lethargy, coma, inebriation, seizures, or ventricular arrhythmias. Onset of symptoms is typically within 30 minutes but can be delayed 12-24 hours. Severe complications include asphyxia, hemorrhagic pulmonary edema, and necrotizing chemical pneumonitis that can progress to shock and respiratory failure.

Codes

ICD10CM:
T53.6X1A – Toxic effect of other halogen derivatives of aliphatic hydrocarbons, accidental (unintentional), initial encounter

SNOMEDCT:
111776002 – Toxic effect of hydrocarbon gas

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Last Reviewed:06/20/2018
Last Updated:06/20/2018
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Potentially life-threatening emergency
Hydrocarbon aspiration
A medical illustration showing key findings of Hydrocarbon aspiration : Cough, Fever, Halogenated aromatic hydrocarbon exposure, Petroleum product exposure, Tachycardia, Dyspnea, Tachypnea, Hypoxia
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