Article Text

Download PDFPDF
Clinical management of casualties exposed to lung damaging agents: a critical review


There is no specific antidote for the treatment of casualties exposed to chlorine, phosgene, or mustards; therefore, management is largely supportive. Corticosteroid treatment has been given to casualties accidentally exposed to chlorine. Clinical data on efficacy are inconclusive as the numbers given steroids have been small and the indications for administration unclear. There have been no clinical controlled studies. There is a stronger evidence base from animal studies, particularly from porcine and rodent models. Lung injury induced by phosgene and mustard appears to be mediated by glutathione depletion, lipid peroxidation, free radical generation, and subsequent cellular toxicity. There is limited evidence to suggest that repletion of glutathione reduces and/or prevents lung damage by these agents. This may provide an opportunity for therapeutic intervention.

  • DBcAMP, dibutyryl adenosine 3’5’-cyclic monophosphate
  • ETYA, 5,8,11,4-eicosatetraynoic acid
  • GSH, glutathione
  • LDA, lung damaging agent
  • NAC, N-acetyl cysteine
  • chemical terrorism
  • chlorine
  • lung damaging agents
  • mustard
  • phosgene

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Primary Survey
    Colville Laird