Pneumotox » Drug » Oxygen (dioxygen, O2)

Oxygen (dioxygen, O2)

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Like NO, molecular oxygen or dioxygen or O2 is listed as a drug. Oxygen can cause lung damage known as hyperoxic lung injury (HLI/HOLI). Oxygen can also trigger or potentiate amiodarone-, chemotherapy- and radiation-induced lung injury. Elevated FIO2 above 0.6 for >24hr may cause HLI/HOLI. See PMID: 21994818, 22804568, 23271823. See also PMID 4936578, 4948324, 6247652, 9887137, 15485081, 20430708, 25314313. And an interesting study in pigs at PMID 10924582

Last update : 26/01/2017

I.l Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf)

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I.v Abnormal lung function/pulmonary physiology (PFTs) without necessarily imaging or clinical evidence

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II.a Pulmonary edema, noncardiogenic (NCPE)

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II.b ARDS - Acute lung injury

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VIII.d Thermal (burns, frostbite), chemical or caustic injury on the face, mouth, tongue, pharynx or upper airway

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VIII.k Airway fire/explosion

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IX.p Disordered breathing during sleep - Sleep apnea

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XI.b Chest pain (acute or subacute), lone or prominent

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XI.e Respiratory acidosis - Hypercapnia

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XV.f Path: Diffuse alveolar damage (DAD-pattern) (see also IL)

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XV.h Path: NSIP-fibrotic pattern

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XVI.bj Imaging: Atelectasis (a combination of increased density and volume loss. Typically lobar)

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XIX.b BAL: An excess proportion of neutrophils

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Diagnosing DIRD

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Drug and radiation history

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Drug singularity - Correct identification of the drug

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Consistent timing of exposure v. onset of symptoms

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Clinical, imaging, BAL, pathological pattern consistent with the specific drug

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Careful exlusion of another cause

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Remission of symptoms with removal of drug

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Recurrence with rechallenge (rarely advisable)

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Causality assessment

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