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Hydrocarbon Inhalation Injury Workup

  • Author: Rakesh Vadde, MBBS; Chief Editor: Michael R Bye, MD  more...
Updated: Apr 18, 2014

Laboratory Studies

When solvent-inhalant abuse is suspected, specific solvent identification should be requested from the laboratory because solvent inhalants are infrequently included in routine toxicologic screening tests.[38]

Complete toxicology screening should be performed because patients who abuse one drug may be simultaneously abusing others.

Perform serologic investigation of renal and hepatic dysfunction, as well as blood and urine testing for rhabdomyolysis.

Obtain serum electrolyte levels to diagnose hypokalemia, hypophosphatemia, hypercalcemia, and acidosis from distal renal tubular acidosis caused by chronic hydrocarbon abuse.

If indicated from the history and physical examination, laboratory tests should be performed for sexually transmitted disease and, possibly, pregnancy (due to disinhibition and poor judgment). Pregnancy testing should be performed in all solvent-abusing females of reproductive age because of the risk of toluene embryopathy.


Other Tests

The following are also indicated:

  • ECG and echocardiography - To identify pulmonary hypertension, evaluate for cardiomyopathy, identify and document dysrhythmias
  • Pulmonary function testing to look for evidence of restrictive disease
  • Neurophysiologic and neuropsychiatric tests for patients with evidence of chronic inhalant use
  • Neuromotor testing in patients with symptoms of peripheral neuropathy
Contributor Information and Disclosures

Rakesh Vadde, MBBS Fellow in Pulmonary Medicine, Interfaith Medical Center

Rakesh Vadde, MBBS is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Thoracic Society

Disclosure: Nothing to disclose.


M Frances J Schmidt, MD Chief of Pulmonary Medicine, Pulmonary Fellowship Program, Teaching Attending Physician, Department of Medicine, Interfaith Medical Center

M Frances J Schmidt, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians

Disclosure: Nothing to disclose.

Divya Salhan, MD Resident Physician, Department of Internal Medicine, Interfaith Medical Center

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Charles Callahan, DO Professor, Chief, Department of Pediatrics and Pediatric Pulmonology, Tripler Army Medical Center

Charles Callahan, DO is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American College of Osteopathic Pediatricians, American Thoracic Society, Association of Military Surgeons of the US, Christian Medical and Dental Associations

Disclosure: Nothing to disclose.

Chief Editor

Michael R Bye, MD Professor of Clinical Pediatrics, State University of New York at Buffalo School of Medicine; Attending Physician, Pediatric Pulmonary Division, Women's and Children's Hospital of Buffalo

Michael R Bye, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

Girish D Sharma, MD, FCCP, FAAP Professor of Pediatrics, Rush Medical College; Director, Section of Pediatric Pulmonology and Rush Cystic Fibrosis Center, Rush Children's Hospital, Rush University Medical Center

Girish D Sharma, MD, FCCP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, Royal College of Physicians of Ireland

Disclosure: Nothing to disclose.


Heidi Connolly, MD Associate Professor of Pediatrics and Psychiatry, University of Rochester School of Medicine and Dentistry; Director, Pediatric Sleep Medicine Services, Strong Sleep Disorders Center

Heidi Connolly, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Jason M Kane, MD, FAAP Assistant Professor of Pediatrics, Northwestern University Feinberg School of Medicine; Attending Physician, Department of Pediatrics, Section of Pediatric Critical Care and Cardiac Intensive Care, Children's Memorial Hospital

Jason M Kane, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Emily B Nazarian, MD Assistant Professor of Pediatrics, Fellowship Director, Pediatric Critical Care, Golisano Children's Hospital at Strong

Emily B Nazarian, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

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Anteroposterior view of the chest of 14-month-old boy 30 hours after ingesting lamp oil. Note the central right lower lobe infiltrate obscuring the right heart border.
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