Nitrous oxide toxicity

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

Differential Diagnosis

Acute complications

• Pneumothorax (induced by forceful inhalation or high preassure tank siphoning)
• Typanic membrane rupture
• Tracheal trauma
• Air emboli

Chronic complications

• Bone marrow suppression (from long term exposure)
  • Leukopenia
  • Megaloblastic anemia
  • Thrombocytopenia