/SRP:/ Immediate first aid: Ensure that adequate decontamination has been carried out. If patient is not breathing, start artificial respiration, preferably with a demand valve resuscitator, bag-valve-mask device, or pocket mask, as trained. Perform CPR if necessary. Immediately flush contaminated eyes with gently flowing water. Do not induce vomiting. If vomiting occurs, lean patient forward or place on the left side (head-down position, if possible) to maintain an open airway and prevent aspiration. Keep patient quiet and maintain normal body temperature. Obtain medical attention. /Poisons A and B/
/SRP:/ Basic treatment: Establish a patent airway (oropharyngeal or nasopharyngeal airway, if needed). Suction if necessary. Watch for signs of respiratory insufficiency and assist ventilations if needed. Administer oxygen by nonrebreather mask at 10 to 15 L/min. Monitor for pulmonary edema and treat if necessary ... . Monitor for shock and treat if necessary ... . Anticipate seizures and treat if necessary ... . For eye contamination, flush eyes immediately with water. Irrigate each eye continuously with 0.9% saline (NS) during transport ... . Do not use emetics. For ingestion, rinse mouth and administer 5 mL/kg up to 200 mL of water for dilution if the patient can swallow, has a strong gag reflex, and does not drool ... . Cover skin burns with dry sterile dressings after decontamination ... . /Poisons A and B/
来源:Hazardous Substances Data Bank (HSDB)
毒理性
解毒与急救
/SRP:/ 高级治疗：对于无意识、严重肺水肿或严重呼吸困难的病人，考虑进行口咽或鼻咽气管插管以控制气道。使用气囊面罩装置的正压通气技术可能有益。考虑使用药物治疗肺水肿……。对于严重的支气管痉挛，考虑给予β激动剂，如沙丁胺醇……。监测心率和必要时治疗心律失常……。开始静脉输注D5W /SRP: "保持开放"，最低流量/。如果出现低血容量的迹象，使用0.9%生理盐水（NS）或乳酸林格氏液。对于伴有低血容量迹象的低血压，谨慎给予液体。注意液体过载的迹象……。使用地西泮或劳拉西泮治疗癫痫……。使用丙美卡因氢氯化物协助眼部冲洗……。 /Poisons A and B/
/SRP:/ Advanced treatment: Consider orotracheal or nasotracheal intubation for airway control in the patient who is unconscious, has severe pulmonary edema, or is in severe respiratory distress. Positive-pressure ventilation techniques with a bag valve mask device may be beneficial. Consider drug therapy for pulmonary edema ... . Consider administering a beta agonist such as albuterol for severe bronchospasm ... . Monitor cardiac rhythm and treat arrhythmias as necessary ... . Start IV administration of D5W /SRP: "To keep open", minimal flow rate/. Use 0.9% saline (NS) or lactated Ringer's if signs of hypovolemia are present. For hypotension with signs of hypovolemia, administer fluid cautiously. Watch for signs of fluid overload ... . Treat seizures with diazepam or lorazepam ... . Use proparacaine hydrochloride to assist eye irrigation ... . /Poisons A and B/
/CASE REPORTS/ ...A male patient /had/ a 35-year history of optical lens grinding, an occupation associated with exposure to cerium oxide, a rare earth metal-containing compound. The patient presented with progressive dyspnea and an interstitial pattern on chest X-ray; open lung biopsy showed interstitial fibrosis histologically indistinguishable from usual interstitial pneumonitis. However, scanning electron microscopy with energy-dispersive X-ray analysis demonstrated numerous particulate deposits in the lung, of which the majority contained the rare earth metal cerium alone or in combination with other elements. /This/ case is one of the first to describe rare earth pneumoconiosis associated with pulmonary fibrosis in the occupational setting of optical lens manufacture. Besides reinforcing the contention that rare earth metals are potentially harmful, /the/ case suggests that such agents may be causally related to the development of pulmonary fibrosis. /Cerium oxide/
...A stepwise approach to identify, design, synthesize, and test new high atomic number particulate contrast agents that would be especially well suited for use with computed tomography (CT). Our goal was to produce extremely radiopaque compounds with highly selective biodistribution to the normal liver. In this way, dose requirements could be lessened and toxicity minimized. Suspensions of cerium, gadolinium, and dysprosium oxide particles and silver iodide colloid were tested and compared with standard agents. All four experimental agents were selectively concentrated in the reticuloendothelial systems of rats and rabbits.
The forms of cerium used in most animal studies ... are included in the slow- and intermediate-clearance categories. Animal studies have shown that clearance from the nasopharyngeal and tracheobronchial regions is fairly rapid for both groups of compounds and that about 80% to 90% of the initial body burden (IBB) is cleared within 7 days after inhalation ... ..
In humans, 5% to 10% of the deposited particles with intermediate clearance would be absorbed into the blood from the nasopharyngeal region and 50% from the tracheobronchial region; in contrast, only 1% of the deposited particles with slow clearance would be absorbed into the blood from these regions.
Clearance of material from the lung is slower than from the other regions of the respiratory tract and generally can be described by a two-phase curve with an initial, relatively rapid phase and slow longer-term phase. Cerium deposited in the alveolar region can be cleared to the gastrointestinal tract (via mucociliary movement) or to the lymph nodes, or absorbed into the systemic circulation. A portion may remain in the lung. Although soluble forms of cerium can rapidly dissolve and be absorbed in the circulation, clearance to the tracheobronchial lymph nodes is thought to be an important pathway by which insoluble cerium forms leave the pulmonary region. The NCRP /in 1978/ predicted that in the intermediate-clearance group 80% of the material deposited in the lung would clear to the gastrointestinal tract (40% with a half life of 1 day and 40% with a half life of 50 days), 15% would translocate to the blood, and 5% would translocate to the pulmonary lymph nodes (with a halflife of 50 days). For cerium with slow clearance, 80% would also be cleared to the gastrointestinal tract (40% with a half life of 1 day and 40% with a half life of 500 days), 5% would enter the blood, and 15% would reach the lymph nodes (with a half life of 1,000 days). For example, cerium in the lymph nodes increased for up to 250 days after a single inhalation of cerium oxide but not after inhalation of cerium chloride.
