Some patients exposed to nitrogen oxides will develop a chemical pneumonitis with acute lung injury (ALI) several hours after the exposure.
Onset: respiratory symptoms develop 3 to 24 hours after the exposure to nitrogen oxides following an asymptomatic period
Clinical features:
(1) shortness of breath
(2) hemoptysis
(3) tachypnea
(4) hypoxemia
(5) rales
(6) bronchospasm
(7) chest tightness
(8) methemoglobinemia
(9) hypotension
Radiographic findings may include:
(1) perihilar infiltrates (initial)
(2) diffuse infiltrates (later)
Therapy with corticosteroids can improve respiratory findings.
The mortality rate can be high in severe and progressive cases.
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Specialty: Toxicology, Emergency Medicine, Critical Care
