Akademik Veri Yönetim Sistemi
The Anesthesiology and Reanimation Specialists’ Society (ARUD) Balkan Countries Anesthesia Days - VIII, Ankara, Türkiye, 28 - 30 Mayıs 2023, cilt.31, sa.1, ss.140-141
ABSTRACT
Background: N,N-dimethylformamide (DMF) is a colorless, odorless and volatile liquid that is miscible with water and most organic liquids
and is used in various industrial applications. Exposure to DMF is mainly through the dermal and respiratory systems. After exposure to DMF,
it is mainly metabolized in the liver and the metabolites are excreted by the kidneys. Acute or chronic occupational exposure to this solvent
is hepatotoxic and may cause poisoning.(1) We aimed to present the intensive care management of a patient who developed acute hepatitis
after serious occupational dimethylformamide exposure.
Case: A 22-year-old male patient applied to the emergency department with complaints of nausea, vomiting, diarrhea and fever after exposure
to dimethylformamide at work. The patient was admitted to the intensive care unit with the diagnosis of acute toxic hepatitis. The patient had
no history of additional disease or previous hepatitis. Hepatobiliary ultrasound was performed in the patient with high liver function tests,
and hepatitis markers were negative. Viral infection-associated and alcoholic hepatitis were ruled out. In the intensive care unit, hepatotoxic
agents were avoided and n acetyl cysteine and symptomatic supportive treatment were given. At the end of the 6-day follow-up, the patient
was discharged, whose symptoms improved and liver function tests decreased.
Discussion: Occupational exposure limits for dimethylformamide is 10 ppm or 30 mg/m3 as an 8-hour time-weighted average (TWA) according
to Occupational Safety and Health Administration (OSHA) and American Conference of Governmental Industrial Hygienists (ACGIH).(2,3) In
recent years, poisoning cases associated with occupational exposure to DMF have been reported. Findings of this toxic solvent exposure are
nonspecific, they can be confused with many diseases in terms of differential diagnosis. There is no specific antidote to DMF, treatment is
supportive.
Conclusion: The use of DMF in the industrial field is increasing day by day and cases of acute and chronic poisoning related to occupational
exposure are reported. The target organ is the liver, and especially severe hepatotoxicity should be monitored in the intensive care unit.
Keywords: Intensive care; Hepatotoxicity; N,N-dimethylformamide; Occupational exposure; Toxic Hepatitis