Phosgene Toxicity Clinical Manifestations and Treatment: A Systematic Review

Document Type : Systematic Review


Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran


Exposure to phosgene, a colourless poisonous gas, can lead to various health issues including eye irritation, a dry
and burning throat, vomiting, coughing, the production of foamy sputum, difficulty in breathing, and chest pain. This
systematic review aims to provide a comprehensive overview of the clinical manifestations and treatment of phosgene
toxicity by systematically analyzing available literature. The search was carried out on various scientific online databases
to include related studies based on inclusion and exclusion criteria with the use of PRISMA guidelines. The quality of
the studies was assessed using the Mixed Methods Appraisal Tool (MMAT). Thirteen articles were included in this
study after the screening process. Inhalation was found to be the primary health problem of phosgene exposure with
respiratory symptoms such as coughing and dyspnea. Chest pain and pulmonary oedema were also observed in some
cases. Furthermore, pulmonary crackle was the most common reported physical examination. Beyond respiratory tract
health issues, other organs involvements such as cardiac, skin, eye, and renal were also reported in some studies. The
symptoms can occur within minutes to hours after exposure, and the severity of symptoms depends on the amount of
inhaled phosgene. The findings showed that bronchodilators can alleviate symptoms of bronchoconstriction caused
by phosgene. Oxygen therapy is essential for restoring oxygen levels and improving respiratory function in cases
of hypoxemia. In severe cases, endotracheal intubation and invasive mechanical ventilation are used for artificial
respiration, along with the removal of tracheal secretions and pulmonary oedema fluid through suctioning as crucial
components of supportive therapy.


Main Subjects

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