Nitrous oxide toxicity: Difference between revisions
(Add thrombotic events to acute complications) |
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===Acute complications=== | ===Acute complications=== | ||
*[[Pneumothorax]] (induced by forceful inhalation or high-pressure tank siphoning) | *[[Pneumothorax]] (induced by forceful inhalation or high-pressure tank siphoning) | ||
* | *Tympanic membrane rupture | ||
*Tracheal trauma | *Tracheal trauma | ||
*[[Air emboli]] | *[[Air emboli]] | ||
*Thrombotic events (typically in chronic use from homocysteine elevation) | *Thrombotic events (rare, typically in chronic use from homocysteine elevation) | ||
**[[Venous thromboembolism]] | **[[Venous thromboembolism]] | ||
**[[Acute arterial ischemia]] | **[[Acute arterial ischemia]] | ||
Revision as of 07:42, 5 August 2025
Background
- Nitrous oxide toxicity is often associated with inhalation of whipped cream or small nitrous oxide cannisters (whippets)
- Nitrous is much more soluble in blood and will quickly diffuse from the blood to a closed space
- Beyond the gaseous effects nitrous oxide mainly disrupts B12 by oxidizing the cobolt ion which irreversibly inhibits methionine synthase[1]
Clinical Features
Differential Diagnosis
Acute complications
- Pneumothorax (induced by forceful inhalation or high-pressure tank siphoning)
- Tympanic membrane rupture
- Tracheal trauma
- Air emboli
- Thrombotic events (rare, typically in chronic use from homocysteine elevation)
Chronic complications
- Bone marrow suppression (from long term exposure)
Evaluation
Workup
Diagnosis
Management
Disposition
See Also
External Links
References
- ↑ Nunn J. Clinical aspects of the interaction between nitrous oxide and vitamin B12. British Joural of Anaesthesia. 1987; 59:3-13