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Table 1 Salient markers of acute respiratory tract injury of phosgene and chlorine in rats

From: Phosgene-induced acute lung injury (ALI): differences from chlorine-induced ALI and attempts to translate toxicology to clinical medicine

  Phosgene Chlorine
Subjective symptoms Absent Eye and airway irritation
Sensory irritation-URT Absent Marked
Bronchial airway injury Minimal, if any Marked
Surfactant deterioration Marked Dose-dependent
Sensory irritation-LRT Marked Dose-dependent
Alveolar macrophage injury Marked Dose-dependent
Pulmonary vascular dysfunction Marked Dose-dependent
Cardiopulmonary dysfunction Marked Marked
Early lung edema Extreme doses Dose-dependent
Onset of lung edema Maximum 15–20 h Instant
Primary countermeasure Lung edema Lung edema & obliterating airway injury
Secondary countermeasure Rapid recovery Lingering airway injury
Clinical guidance on inhaled dose Phosgene dosimeters Environmental analyses (if available)
Prognostic approaches Hemoglobin, eNO, eCO2 Irritation severity, fibrin
  1. URT upper respiratory tract, LRT lower respiratory tract, eNO exhaled nitric oxide, eCO 2 exhaled carbon dioxide