Zusammenfassung
Nach akuter Inhalation von Schadstoffen kann es zu Schäden im Bereich der gesamten Atemwege kommen. Stoffeigenschaften und Dosis bestimmen den Depositionsort. Es resultieren die Krankheitsbilder einer toxischen Alveolitis oder eines Reactive Airways Dysfunction Syndrome (RADS). Sonderformen stellen die Inhalationsfieber dar. Die Schwere der Erkrankung reicht von milden Verläufen bis hin zu einer lebensbedrohlichen toxischen Alveolitis. Die Diagnostik stützt sich im Wesentlichen auf den engen zeitlichen Zusammenhang zwischen einer akuten Schadstoffinhalation und den Beschwerden bzw. dem Krankheitsbild. Die Therapie der toxischen Inhalationsschäden ist primär supportiv. Der Einsatz einer Therapie mit Kortikosteroiden ist in Abhängigkeit vom Krankheitsbild und vom inhalierten Schadstoff differenziert zu entscheiden.
Abstract
Acute exposure to toxic substances can lead to inhalation injury of the whole respiratory tract. The site of deposition is dependent on the characteristics and the dose of the inhaled substance. This typically results in toxic alveolitis and reactive airways dysfunction syndrome (RADS), whereby inhalation fevers constitute a special form of inhalation injury. Disease severity varies from a mild course to severe lung injury with life-threatening toxic alveolitis. The diagnosis is essentially based on the demonstration of a close temporal relationship between acute inhalation of a toxic substance and the complaints and symptoms. The treatment of acute inhalation injury is primarily supportive. The administration of corticosteroids is a matter of discussion but should be decided after taking the disease entity and the inhaled toxic substance into account.
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C. Steiner, C. Eisenhawer und R. Merget geben an, dass kein Interessenkonflikt besteht.
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Steiner, C., Eisenhawer, C. & Merget, R. Lungenschädigung durch akute Schadstoffinhalation. Pneumologe 16, 160–167 (2019). https://doi.org/10.1007/s10405-019-0241-y
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DOI: https://doi.org/10.1007/s10405-019-0241-y
Schlüsselwörter
- Toxizität
- Alveolitis
- Pneumonitis
- World-Trade-Center-Anschlag, 2001
- Toxische Substanzen, umgebungsbedingt