Sudden sniffing death syndrome
| Sudden sniffing death syndrome | |
|---|---|
| Other names: Sudden sniffing death, cardiac sensitization syndrome[1] | |
 | |
| A man huffing an inhalant | |
 | |
| Specialty | Toxicology |
| Symptoms | Sudden death[2] |
| Usual onset | Within minutes to hours of use[3][4] |
| Causes | Inhalant misuse[2] |
| Risk factors | Being startled, physical activity[2][5] |
| Treatment | CPR, defibrillation beta blockers[1] |
| Prognosis | Poor[6] |
| Deaths | 50 to 100 per year (USA)[3][2] |
Sudden sniffing death syndrome (SSDS) is sudden death due to inhalant misuse.[2] Onset is within minutes to hours of substance use.[3][4] Being startled or physical activity may trigger its onset.[2][5]
It most commonly occurs due to use of butane, propane, or aerosols.[3] It can occur after a single session of breathing in the chemicals; with about 20% of cases occur with first time use.[6][3] The underlying mechanism often involves an irregular heart rate, specifically ventricular fibrillation due to catecholamine release.[3][2] Other cases may result from lack of oxygen or an allergic reaction.[5]
Treatment is similar to other causes of atrial fibrillation with CPR and defibrillation, except epinephrine is not recommended and beta-blockers (such as esmolol) may be used.[2][1] Defibrillation; however, may not be effective initially.[4] Outcomes are generally poor.[6]
In the United States inhalants result in about 100 to 200 deaths per year.[3] About half of these are a result of SSDS.[2] In the United States those most commonly affected are young white males, despite similar use rates between the sexes.[5] The condition was first described in 1970 by Bass.[4]
References
- ↑ 1.0 1.1 1.2 Zimmerman, Janice L. (4 June 2021). Toxicology, An Issue of Critical Care Clinics, E-Book: Toxicology, An Issue of Critical Care Clinics, E-Book. Elsevier Health Sciences. p. 693. ISBN 978-0-323-79454-1. Archived from the original on 15 July 2023. Retrieved 13 July 2023.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Anderson, Carrie E.; Loomis, Glenn A. (1 September 2003). "Recognition and Prevention of Inhalant Abuse". American Family Physician. 68 (5): 869–874. Archived from the original on 8 May 2023. Retrieved 13 July 2023.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 "What are the other medical consequences of inhalant abuse?". National Institute on Drug Abuse. 2023. Archived from the original on 6 May 2023. Retrieved 13 July 2023.
- ↑ 4.0 4.1 4.2 4.3 George, N; Chin, B; Neeki, AS; Dong, F; Neeki, MM (November 2021). "Acute Inhalant-Induced Atrial Fibrillation With Severe Hypocalcemia: A Case Report and Review of the Pathophysiology". Cureus. 13 (11): e19897. doi:10.7759/cureus.19897. PMID 34966608.
- ↑ 5.0 5.1 5.2 5.3 Bowen, Scott E. (24 May 2011). "Two Serious and Challenging Medical Complications Associated with Volatile Substance Misuse: Sudden Sniffing Death and Fetal Solvent Syndrome". Substance Use & Misuse. 46 (sup1): 68–72. doi:10.3109/10826084.2011.580220.
- ↑ 6.0 6.1 6.2 Miller, Norman S.; Gold, Mark S. (26 July 2011). Addictive Disorders in Medical Populations. John Wiley & Sons. p. PT635. ISBN 978-1-119-95630-3. Archived from the original on 15 July 2023. Retrieved 13 July 2023.