Acute lung and lower respiratory tract damage after inhalation exposure to hydrogen fluoride

Abstract

Relevance. Hydrogen fluoride is a highly active chemical substance widely used in industry for production of inorganic fluorides, organofluorine compounds, in the processing of aluminum, stainless steel and alloys. The chemical properties of hydrogen fluoride determine its ability to have a destructive effect on the tissues of the human body and high toxicity with local and systemic exposure. Hydrogen fluoride poisoning is severe and difficult to treat. Clarification of the clinical picture and the search for new methods of treating lesions with hydrogen fluoride are of great importance for protecting the health of workers in chemical industries and eliminating the consequences of technogenic accidents.Intention. To consider the features of the observed clinical case of severe damage to the lungs and lower respiratory tract after inhalation exposure to hydrogen fluoride and treatment methods that made it possible to achieve favorable clinical results. Methodology. The article discusses clinically important chemical properties of hydrogen fluoride, the mechanisms and manifestations of characteristic lesions developing in the human body with various routes of exposure. Modern approaches to the treatment of patients exposed to hydrogen fluoride are outlined.Results and Discussion. Inhalation of gas mixtures, even with low concentrations of hydrogen fluoride, can lead to severe inflammatory-necrotic lung damage with interstitial pneumonia (chemical pneumonitis), adult respiratory distress syndrome, and severe respiratory failure. Improvement of clinical condition of the affected person in the observed case was achieved via complex treatment with glucocorticosteroids, antimicrobial agents, calcium gluconate inhalations. A key role in the patient’s treatment was played by long-term replacement of the impaired function of the lungs using extracorporeal membrane oxygenation.Conclusion. In severe forms of acute damage to the lungs and lower respiratory tract as a result of inhaled exposure to hydrogen fluoride, clinical recovery and improvement in the quality of life of the injured can be achieved through complex therapy using glucocorticosteroids, antibacterial agents, specific antidotes (calcium gluconate) and prolonged replacement of the respiratory function via artificial ventilation and extracorporeal membrane oxygenation.