Acute nitrogen intoxication by patient inhalation with breathing insufficiency and coma: case report - Critical Care Science (CCS)

BACKGROUND AND OBJECTIVES: To present the first case reported in the Brazilian literature of liquid nitrogen intoxication. The objective of this report was to present a case of severe intoxication by liquid nitrogen, with acute lung edema and ischemic encephalopathy, which a good outcome, due to a fast diligence and a proper therapy administration. CASE REPORT: Male patient, 26 years, unconscious for one hour, in a close room with a machine to keep frozen the ice-roller ring. There was evidence of gastric aspiration and laryngeal edema. The intubation was difficult. The patient developed acute lung edema and brain edema due to hypoxia. There was a slow lung resolution with a protective ventilatory strategy for ARDS (VT 5 mL/kg, PEEP de 15 cmH2O) and corticotherapy with hydrocortisone (200 mg) every 6 h to treat bronchospasm. CONCLUSIONS: This the first case published in Brazil of nitrogen intoxication. In the international literature there are several reports of similar cases occurred in gymnasiums for hockey game. There are reports of bronchospasm exacerbations in people after the matches, even up to 10h after exposal to the gases riches in nitrogen.