This report describes a case of metabolic acidosis secondary to acute ammonia (NH3+) inhalation, a complication rarely documented in medical literature. The patient, a 73-year-old man, developed dyspnea after inhaling NH3+ while cleaning a bathroom. Initial diagnoses included acute kidney injury(AKI) and global respiratory failure with mixed acidosis secondary to NH3+ inhalation. Although the patient showed initial respiratory improvement, he experienced moderate renal function deterioration, hyperkalemia, and metabolic acidosis, which required bicarbonate treatment. After 24 hours, his clinical and analytical parameters improved, allowing for hospital discharge. This case highlights the need to consider metabolic alterations in patients exposed to acute NH3+ inhalation and underscores the importance of a multidisciplinary approach to managing respiratory and metabolic complications, thus contributing valuable insights to the literature on ammonia intoxication management and treatment.
Riera et al. (Wed,) studied this question.