Seyed Mansour Razavi,Mostafa Ghanei,Payman Salamati,Mehdi Safiabadi.[J].Chin J Traumatol,2013,16(1):163-168. [doi]

Long-term effects of mustard gas on respiratory system of Iranian veterans after Iraq-Iran war: a review

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KeyWord: Lunginjury Chemicalwarfare Mustardgas

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Author Name	Affiliation
Seyed Mansour Razavi	Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
Mostafa Ghanei	Research Center of Chemical Injuries, Baqiyatallah University of Medical Sciences, Tehran, Iran
Payman Salamati	Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
Mehdi Safiabadi	Baqiyatallah University of Medical Sciences, Tehran, Iran

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Abstract:

To review long-term respiratory effects of mustard gas on Iranian veterans having undergone IraqIran war. Electronic databases of Scopus, Medline, ISI, IranMedex, and Irandoc sites were searched. We accepted articles published in scientific journals as a quality criterion. The main pathogenic factors are free radical mediators. Prevalence of pulmonaryinvolvement is approximately42.5%. The most common complaints are cough and dyspnea. Major respiratory complications are chronic obstructive pulmonary disease, bronchiectasis, and asthma. Spirometry results can reveal restrictive and obstructive pulmonary disease. Plain chest X-ray does not help in about 50% of lung diseases. High-resolution CT of the lung is the best modality for diagnostic assessment of parenchymal lung and bronchi. There is no definite curative treatment for mustard lung. The effective treatment regimens consist of oxygen administration, use of vaporized moist air, respiratory physiotherapy, administration of mucolytic agents, bronchodilators, corticosteroids, and long-acting beta-2 agonists, antioxidants, surfactant, magnesium ions, therapeutic bronchoscopy, laser therapy, placement of respiratory stents, early tracheostomy in laryngospasm, and ultimately lung transplantation. High-resolution CT of the lung is the most accurate modality for the evaluation of the lung parenchyma and bronchi. The treatment efficacy of patients exposed to mustard gas depends on patient conditions (acute or chronic, upper or lower respiratory tract involvement). There are various treatment protocols, but unfortunately none of them is definitely curable.

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