硫化氢中毒病例汇报
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The reason of myocardial damage in hydrogen sulfide poisoning may be hypoxia、myocardial edema、hypoxia reperfusion injury or the toxicity of hydrogen sulfide.
Diagnosis and treatment of hydrogen sulfide poisoning
复旦大学附属金山医院 急危重病中心
male nurs
e
Hydrogen sulfide 中毒气体的KO王者之一
male
nurs
e
气体中毒
Irritants?
Asphyxiant?
一氧化碳carbon monoxide 甲烷methane 硫化氢hydrogen sulfide 氰化氢cyanide 氨气ammonia 氯气chlorine 光气phosgene
*Endogenously produced H2S functions as a signaling molecule in the brain and gastrointestinal (GI) pathologies.（1,2） *H2S in high acute-dose exposures is a severely toxic substance.（3,4）
male nurs
e
The treatment of hydrogen sulfide poisoning
CPR ventilation,O2 adrenaline 高压氧,神经系统功能 心肌功能的损害（insidious，delayed onset） 脏器功能的保护
On the Efficacy of Cardio-Pulmonary Resuscitation and Epinephrine Following Cyanide- and H2S Intoxication-Induced Cardiac Asystole ，Annick Judenherc-HaouzI, Takashi Sonobe, Vikhyat S. Bebarta, and Philippe Haouzi Cardiovasc Toxicol. 2018 October ; 18(5): 436–449.
eபைடு நூலகம்
Coronary artery CT(No.10day)
male nurs
e
Clinical data
Date Myocardial injury indexes
TNI MYO CK-MB BNP H-FABP
Echocardiography indexes
LVEF PASP LVDD LVSD
male nurs
e
Thank you
e
male
Case. Examination improved through conventional echocardiography, radionuclide
nurs e
myocardial perfusion imaging rMPI) and 2D-STI strain.
Hydrogen sulfide poisoning
Hydrogen sulfide
male nurs
e
H2S is a colorless gas and has a distinctive rotten egg odor. It is sometimes referred to as sewer gas. It is heavier than air, and therefore collects in low-lying, enclosed spaces, such as manholes, sewer lines, and manure pits, where it is a hazard.
Summary
male
nurs
e
中毒救治clinical thinking. 知其然，知其所以然。 做一个有“心”的医生。
Article：Acute myocardial injury following hydrogen sulfide poisoning Toxicology and industrial health IF1.6
9
0.77 199 37.6 44.03 3.6
-
12
0.53 169 42.1 30 -
69 20 47 29 30 >1 >1 38
21
0.39 28.9 7.8 20.5 -
62 20 49 33 34 >1 >1 33
GLPS_Avg(%) GLPS_AvgEpi(%) GLPS_AvgEndo(%) Epi(Lateral) Epi(posterior) Epi(anterior) Mid(Lateral) Mid(posterior) Mid(anterior) Endo(Lateral) Endo(posterior) Endo(anterior)
Case.On the fourth day of hospitalization he presented with elevated STsegment and dynamic changes in markers of myocardial injury.(No.4day and No.10day)
Case.Radiologic imaging(No.1day)
nurs e
male
nurs
Case.Radiologic imaging(No.4day and
e
No.10day)
male
Clinical data(No.1day)
nurs e
TNI(-) CK-MB(-) MYO168 BNP50 conciousness vital sign
1. Tan BH, Wong PT & Bian JS. 2010 Hydrogen sulfide: a novel signaling molecule in the central nervous system. Neurochem. Int 56: 3–10. 2. Moustafa A & Habara Y. 2015 Hydrogen sulfide: a novel gaseous signaling molecule and intracellular Ca2+ regulator in rat parotid acinar cells. Am. J. Physiol. Cell Physiol 309: C480– C490. 3. Olas B 2017 Hydrogen sulfide as a “double-faced” compound: one with pro- and antioxidant effect. Adv. Clin. Chem 78: 187–196. 4. Gadalla MM & Snyder SH. 2010 Hydrogen sulfide as a gasotransmitter. J. Neurochem 113: 14–26.
LAD E/A E'/A' FS% Peak systolic strain
1
0.05 146 2.8 43.6 6.9
-
4
0.12 470 48.7 131 25.6
68 21 47 29 30 >1 >1 38
6
0.11 175 48.1 208.95 15.1
70 20 47 29 31 >1 >1 40
OSHA. Hydrogen sulfide In OSHA Fact Sheet. Vol. 2015 Accessed June 16, 2017
male nurs
e
Case. the poisoning of hydrogen sulfide
A 20-year-old male suddenly fell to the ground after entering the asphalt tank at 9:00am.
male
nurs
Hydrogen sulfide
e
*Hydrogen sulfide (H2S) is typical of compounds that are beneficial at
normal physiological concentrations but toxic at high doses.
He was immediately transferred to the local hospital. On arrival at the hospital, his vital signs were Bp 170/87 mmHg, Sp02 96%, HR 102 bpm, breathing rate 12 bpm.
At 12:00 Bp 107/67 mmHg, HR 88 bmp, SpO2 95%, GCS of 4 and APACHE II score of 24. He was then transferred to the ICU in our hospital.
the poisoning of hydrogen sulfide
The damage of myocardial function is sometimes more insidious, and even has the possibility of delayed onset.
The recovery of myocardial damage may be slow.
male nurs
e
consciousness vital sign
clinical symptoms
male
Case.On the fourth day of hospitalization he presented with
nurs
dynamic changes in markers of myocardial injury.
-16.1 -14.1 -18.6
8 -9 -13
7 -11 -15
7 -13 -16
-16.8 -14.0 -20.1 -3 -7 -13 -4 -8 -14 -4 -10 -14
-16.2 -13.9 -18.8 -14 -5 -13 -13 -8 -13 -13 -11 -13
male nurs
male nurs
e
Hydrogen sulfide poisoning can easily lead to central nervous system and respiratory system lesions, of course, it can also cause myocardial damage.
male nurs
e
consciousness(linghtning-like, knock down) vital sign CPR 120 transport epilepsy endotracheal intubation, ventilation adrenaline
male
Diagnosis and treatment of hydrogen sulfide poisoning
复旦大学附属金山医院 急危重病中心
male nurs
e
Hydrogen sulfide 中毒气体的KO王者之一
male
nurs
e
气体中毒
Irritants?
Asphyxiant?
一氧化碳carbon monoxide 甲烷methane 硫化氢hydrogen sulfide 氰化氢cyanide 氨气ammonia 氯气chlorine 光气phosgene
*Endogenously produced H2S functions as a signaling molecule in the brain and gastrointestinal (GI) pathologies.（1,2） *H2S in high acute-dose exposures is a severely toxic substance.（3,4）
male nurs
e
The treatment of hydrogen sulfide poisoning
CPR ventilation,O2 adrenaline 高压氧,神经系统功能 心肌功能的损害（insidious，delayed onset） 脏器功能的保护
On the Efficacy of Cardio-Pulmonary Resuscitation and Epinephrine Following Cyanide- and H2S Intoxication-Induced Cardiac Asystole ，Annick Judenherc-HaouzI, Takashi Sonobe, Vikhyat S. Bebarta, and Philippe Haouzi Cardiovasc Toxicol. 2018 October ; 18(5): 436–449.
eபைடு நூலகம்
Coronary artery CT(No.10day)
male nurs
e
Clinical data
Date Myocardial injury indexes
TNI MYO CK-MB BNP H-FABP
Echocardiography indexes
LVEF PASP LVDD LVSD
male nurs
e
Thank you
e
male
Case. Examination improved through conventional echocardiography, radionuclide
nurs e
myocardial perfusion imaging rMPI) and 2D-STI strain.
Hydrogen sulfide poisoning
Hydrogen sulfide
male nurs
e
H2S is a colorless gas and has a distinctive rotten egg odor. It is sometimes referred to as sewer gas. It is heavier than air, and therefore collects in low-lying, enclosed spaces, such as manholes, sewer lines, and manure pits, where it is a hazard.
Summary
male
nurs
e
中毒救治clinical thinking. 知其然，知其所以然。 做一个有“心”的医生。
Article：Acute myocardial injury following hydrogen sulfide poisoning Toxicology and industrial health IF1.6
9
0.77 199 37.6 44.03 3.6
-
12
0.53 169 42.1 30 -
69 20 47 29 30 >1 >1 38
21
0.39 28.9 7.8 20.5 -
62 20 49 33 34 >1 >1 33
GLPS_Avg(%) GLPS_AvgEpi(%) GLPS_AvgEndo(%) Epi(Lateral) Epi(posterior) Epi(anterior) Mid(Lateral) Mid(posterior) Mid(anterior) Endo(Lateral) Endo(posterior) Endo(anterior)
Case.On the fourth day of hospitalization he presented with elevated STsegment and dynamic changes in markers of myocardial injury.(No.4day and No.10day)
Case.Radiologic imaging(No.1day)
nurs e
male
nurs
Case.Radiologic imaging(No.4day and
e
No.10day)
male
Clinical data(No.1day)
nurs e
TNI(-) CK-MB(-) MYO168 BNP50 conciousness vital sign
1. Tan BH, Wong PT & Bian JS. 2010 Hydrogen sulfide: a novel signaling molecule in the central nervous system. Neurochem. Int 56: 3–10. 2. Moustafa A & Habara Y. 2015 Hydrogen sulfide: a novel gaseous signaling molecule and intracellular Ca2+ regulator in rat parotid acinar cells. Am. J. Physiol. Cell Physiol 309: C480– C490. 3. Olas B 2017 Hydrogen sulfide as a “double-faced” compound: one with pro- and antioxidant effect. Adv. Clin. Chem 78: 187–196. 4. Gadalla MM & Snyder SH. 2010 Hydrogen sulfide as a gasotransmitter. J. Neurochem 113: 14–26.
LAD E/A E'/A' FS% Peak systolic strain
1
0.05 146 2.8 43.6 6.9
-
4
0.12 470 48.7 131 25.6
68 21 47 29 30 >1 >1 38
6
0.11 175 48.1 208.95 15.1
70 20 47 29 31 >1 >1 40
OSHA. Hydrogen sulfide In OSHA Fact Sheet. Vol. 2015 Accessed June 16, 2017
male nurs
e
Case. the poisoning of hydrogen sulfide
A 20-year-old male suddenly fell to the ground after entering the asphalt tank at 9:00am.
male
nurs
Hydrogen sulfide
e
*Hydrogen sulfide (H2S) is typical of compounds that are beneficial at
normal physiological concentrations but toxic at high doses.
He was immediately transferred to the local hospital. On arrival at the hospital, his vital signs were Bp 170/87 mmHg, Sp02 96%, HR 102 bpm, breathing rate 12 bpm.
At 12:00 Bp 107/67 mmHg, HR 88 bmp, SpO2 95%, GCS of 4 and APACHE II score of 24. He was then transferred to the ICU in our hospital.
the poisoning of hydrogen sulfide
The damage of myocardial function is sometimes more insidious, and even has the possibility of delayed onset.
The recovery of myocardial damage may be slow.
male nurs
e
consciousness vital sign
clinical symptoms
male
Case.On the fourth day of hospitalization he presented with
nurs
dynamic changes in markers of myocardial injury.
-16.1 -14.1 -18.6
8 -9 -13
7 -11 -15
7 -13 -16
-16.8 -14.0 -20.1 -3 -7 -13 -4 -8 -14 -4 -10 -14
-16.2 -13.9 -18.8 -14 -5 -13 -13 -8 -13 -13 -11 -13
male nurs
male nurs
e
Hydrogen sulfide poisoning can easily lead to central nervous system and respiratory system lesions, of course, it can also cause myocardial damage.
male nurs
e
consciousness(linghtning-like, knock down) vital sign CPR 120 transport epilepsy endotracheal intubation, ventilation adrenaline
male