Fluoropolymer Fume 흡입으로 인한 급성 호흡곤란 증후군 1예

Abstract

Fluoropolymer compounds (polytetrafluoroethylene-PTFE, Teflon®) can produce a clinical syndrome, polymer fume fever, when the products from their thermal decomposition are inhaled. Polymer fume fever is characterized by fever, dyspnea, a non-productive cough, and headaches after exposure to the pyrolytic products. We report a case of acute respiratory distress syndrome after the inhalation of fumes produced from overheated fluoropolymer compounds. A 60-year-old male came to the emergency department complaining of severe dyspnea, nausea, coughing. Just one day ago, he worked in a fluoropolymer-processing factory without any protective mask device. Initial arterial blood gas analysis showed a composition of pH 7.4, arterial partial oxygen pressure 46.0 mmHg and oxygen saturation 79% of room air. Chest computerized tomography revealed a bilateral diffuse consolidation and ground glass appearance. Polymer fume fever and acute respiratory distress syndrome was suspected by the symptoms, history of exposure, and radiologic findings. The patient received ventilatory support with a mechanical ventilator, intravenous corticosteroids, and intravenous N-acetylcysteine. His symptoms and oxygen saturation completely resolved over 6 days. In summary, when fluoropolymers compounds are heated the fumes generated can cause polymer fume fever with severe toxic effects, such as acute respiratory distress syndrome, pulmonary edema, and pneumonitis. The clinical presentation, radiologic findings, and the management of polymer fume fever are reviewed here.