Hydrocarbon Poisoning

Basics

Description

  • Main complication from hydrocarbon exposure is aspiration
  • Hydrocarbon aspiration primarily affects central nervous and respiratory systems
  • Physical properties determine type and extent of toxicity:
    • Viscosity (resistance to flow):
      • Higher aspiration risk from products with lower viscosity
    • Volatility (ability of a substance to vaporize):
      • Hypoxia from aromatic hydrocarbons displacing alveolar air
    • Surface tension (ability to adhere to itself at liquid's surface):
      • Low surface tension allows easy spread from oropharynx to trachea, promoting aspiration (e.g., mineral oil, seal oil)
  • Volatile-substance abuse:
    • Common solvents abused:
      • Typewriter correction fluid
      • Adhesive
      • Gasoline
      • Cigarette-lighter fluid
    • Sniffing: Product inhaled directly from container
    • Huffing: Product inhaled through a soaked rag held to face
    • Bagging: Product poured into bag and multiple inhalations taken from bag
  • Major classes of hydrocarbons:
    • Aliphatics:
      • Include kerosene, mineral oil, seal oil, gasoline, solvents, and paint thinners
      • Pulmonary toxicity via aspiration
      • Asphyxiation from gaseous methane and butane by displacement of alveolar oxygen
    • Halogenated hydrocarbons:
      • Include carbon tetrachloride and trichloroethane
      • Found in industrial settings as solvents
      • Well absorbed by lungs and gut
      • High toxicity
      • Liver and renal failure associated with ingestion
    • Cyclics or aromatic compounds include toluene and xylene:
      • Highly volatile and well absorbed from gut
      • Death from benzene reported with 15 mL ingestion
    • Terpenes or wood distillates include turpentine and pine oil:
      • Significant GI tract absorption
      • Significant CNS depression

Etiology

  • Accidental exposures typical in young children
  • Inhalation abuse of volatile hydrocarbons
  • Suicide attempts in adolescents and adults

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