Acute Respiratory Distress Syndrome (ARDS) After Nitric Acid Inhalation

Lung injury resulting from inhalation of chemical products continues to be associated with high morbidity and mortality. Concentrated nitric acids are also extremely corrosive fuming chemical liquids. Fumes of nitric acid (HNO3) and various oxides of nitrogen such as nitric oxide (NO) and nitrogen dioxide (NO2) may cause fatal illnesses such as severe pulmonary edema and acute respiratory distress syndrome (ARDS) when inhaled. Intensive respiratory management including mechanical ventilation with positive end expiratory pressure (PEEP), inverse ratio ventilation, replacement of surfactant and extracorporeal membrane oxygenation (ECMO), steroids and n- acetylcysteine (NAC) may improve survival. In this case report we present the diagnosis and successful treatment of a 57 years old male patient who developed ARDS following pulmonary edema due to nitric acid fumes inhalation.