Inhalation of toxic gases in the kiss nightclub disaster: an example of inhalation injury from indoor fires
Inalação de gases tóxicos no desastre da boate kiss: um exemplo de injúria por inalação em incêndios internos
DOI:
https://doi.org/10.34117/bjdv8n12-182Keywords:
fires, smoke inhalation injuries, carbon monoxide poisoning, cyanide, disastersAbstract
The Kiss Nightclub disaster, which occurred on January 27, 2013, in Santa Maria, Brazil, had an impact both on a national and global scale, as it was an accident with 230 immediate fatalities and can be compared to other indoors fires. In addition to bodily burns, inhalation injuries stood out, that is, thermal injuries of the airway, chemical injuries and intoxication by toxic gases. Carbon monoxide and cyanide are the main toxic gases produced in indoor fire situations and are formed from the incomplete combustion of hydrocarbons and carbonaceous and nitrogenous materials, respectively. While carbon monoxide, at high concentrations in the blood, promotes a shift of the oxyhemoglobin curve to the left and a consequent hypoxia condition, cyanide blocks the respiratory cycle, activating anaerobic respiration and evolving to an excessive production of lactic acid, which can lead the victim to death. Considering that in the accident of Santa Maria 169 individuals were hospitalized in a critical condition, it is necessary to understand the consequences and pathophysiology of inhalation injuries, being that the focus of this narrative review is the knowledge about poisoning by toxic gases. Moreover, it is essential to discuss proper diagnosis and treatment, in order to improve the prognosis of future victims of new fires in closed environments. Therefore, having knowledge about the potential causes of indoor fires helps in the prevention of similar disasters to the one that happened in the Kiss Nightclub.
References
Atiyeh B. Brazilian Kiss nightclub disaster. Rev Bras Cir Plást. 2013 May 29; 27 (4). Portuguese. Available at: https://pubmed.ncbi.nlm.nih.gov/23966891/
Bassi E, Miranda LC, Tierno PF, Ferreira CB, Cadamuro FM, et al. Assistance of inhalation injury victims caused by fire in confined spaces: what we learned from the tragedy at Santa Maria. Rev Bras Ter Intensiva. 2014 October; 26 (4). Portuguese. Available at: https://pubmed.ncbi.nlm.nih.gov/25607274/
Dries DJ, Endorf FW. Inhalation injury: epidemiology, pathology, treatment strategies. Scand J Trauma Resusc Emerg Med. 2013 April 19; 21:31. Available at: https://pubmed.ncbi.nlm.nih.gov/23597126/
Souza R, Jardim C. Salge JM, Carvalho CRR. Lesão por inalação de fumaça. J Bras Pneumol. 2005 april 07; 30 (6). Portuguese. Available at: https://www.scielo.br/j/jbpneu/a/YSFnqWc79x9JrKLbFgCyR4J/?format=pdf&lang=pt
Casillas S, Galindo A, Reyes LAC, Varon J, Surani SR. Effectiveness of Hyperbaric Oxygenation Versus Normobaric Oxygenation Therapy in Carbon Monoxide Poisoning: A Systematic Review. Cureus. 2019 October 15; 11(10):e5916. Available at: https://pubmed.ncbi.nlm.nih.gov/31788375/
Eichhorn L, Thudium M, Jutter B. The Diagnosis and Treatment of Carbon Monoxide Poisoning. Dtsch Arztebl Int. 2018 December; v.115(51-52). Available at: https://pubmed.ncbi.nlm.nih.gov/30765023/
Hess DR. Inhaled Carbon Monoxide: From Toxin to Therapy. Respir Care. 2017 October; 62(10):1333-1342. Available at: https://pubmed.ncbi.nlm.nih.gov/28807985/
Antonio ACP, Castro PS, Freire LO. Smoke inhalation injury during enclosed-space fires: an update. J Bras Pneumol. June 2013; 39(3). Available at: https://pubmed.ncbi.nlm.nih.gov/23857686/
Kinoshita H, et al. Carbon monoxide poisoning. Toxicol Rep. 2020 January 20; 7: 169-173. Available at: https://pubmed.ncbi.nlm.nih.gov/32015960/
Gozubuyuk AA, et al. Epidemiology, pathophysiology, clinical evaluation, and treatment of carbon monoxide poisoning in child, infant, and fetus. North Clin Instanb. 2017 May 10; v.4(1): 100-107. Available at: https://pubmed.ncbi.nlm.nih.gov/28752154/
Chan MY, Au TT, Leung KS, Yan WW. Acute carbon monoxide poisoning in a regional hospital in Hong Kong: historical cohort study. Hong Kong Med J. 2016 February; 22(1):46-55. Available at: https://pubmed.ncbi.nlm.nih.gov/26769825/
Sun X, et al. Potential use of hyperoxygenated solution as a treatment strategy for carbon monoxide poisoning. PLoS One. 2013 December 2; 8(12):e81779. Available at: https://pubmed.ncbi.nlm.nih.gov/24312588/
Albuquerque IM, Trevisan ME, Pasqualoto AS, et al. Physical therapy performance in the rehabilitation of survivors of the Kiss nightclub tragedy: an experience report. Fisioter Mov. 2015 October; 28(4). Available at: https://www.scielo.br/j/fm/a/h58Nq5FnHVHXGQyPptGCyrH/?lang=en&format=pdf
