HEMODYNAMICS IN PULMONARY IRRITANT POISONING

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Abstract
Some circulatory impairment is evidenced soon after phosgene poisoning by low arterial pressure, prolonged pulmonary circulation time, increased arterial-venous O2 difference and hemoeoncentration with its decreased blood vol. and increased blood viscosity. These may contribute to the final break-down by exaggerating the tissue anoxia already present because of the low arterial O2 saturation. Death, however, is due primarily to an interference with O2 uptake through edematous lungs. If the acute stage of pulmonary edema with its attendant anoxic anoxia is survived, circulatory failure may become a more important factor in the ultimate outcome. There is no increased back-pressure on the right heart under any type or degree of lung pathology produced in dogs by gassing with phosgene. This is indicative of a considerable vascular reserve in the pulmonary circuit and eliminates right heart embarrassment as an important complication of gassing.