{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:33:20Z","timestamp":1784255600367,"version":"3.55.0"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,17]],"date-time":"2025-03-17T00:00:00Z","timestamp":1742169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Ammonia is one of the most commonly produced chemicals in the world, with uses in agriculture, household cleaning, and as an alternative fuel source. While typically encountered in low concentrations, pure anhydrous ammonia in its gaseous form is extremely toxic and a potent caustic. We report the case of a previously healthy 19-year-old with prolonged anhydrous ammonia exposure after a motor vehicle accident caused an inadvertent release of 4000 gallons of anhydrous ammonia. Despite optimal initial medical management, he required venovenous extracorporeal membrane oxygenation (VV-ECMO) in addition to aggressive multispecialty care to address his extensive injuries. After a prolonged hospitalization, he recovered without the need for lung transplantation and returned to activities of daily living. This case highlights the fastidious care necessary to effectively treat those exposed to anhydrous ammonia, including VV-ECMO as a salvage technique.<\/jats:p>","DOI":"10.1177\/2050313x251327670","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T02:15:52Z","timestamp":1742264152000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Management of inhalational injury secondary to prolonged anhydrous ammonia exposure with venovenous ECMO: A case report"],"prefix":"10.1177","volume":"13","author":[{"given":"Paul J.","family":"Fletcher","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University of Kansas Medical Center, KS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3969-0689","authenticated-orcid":false,"given":"Brent","family":"Kidd","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Kansas Medical Center, KS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T.","family":"Zorn","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Thoracic Surgery, University of Kansas Medical Center, KS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Costello","sequence":"additional","affiliation":[{"name":"University of Kansas, Lawrence, KS, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,3,17]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Afshar P Smart S. Five dead in Illinois crash involving semi-truck carrying ammonia as evacuated residents begin to return home. CNN https:\/\/www.cnn.com\/2023\/09\/30\/us\/illinois-anhydrous-ammonia-leak\/index.html (2023 accessed 12 December 2024)."},{"key":"e_1_3_2_3_2","unstructured":"Prokera Package Insert. Doral FL: BioTissue Holdings Inc. 2023. https:\/\/biotissue.com\/wp-content\/uploads\/2022\/05\/Prokera-Product-Insert-1.pdf (accessed 1 December 2024)."},{"key":"e_1_3_2_4_2","unstructured":"Ammonia Solution Ammonia Anhydrous: Lung Damaging Agent. The National Institute for Occupational Safety and Health (NIOSH) www.cdc.gov\/niosh\/ershdb\/emergencyresponsecard_29750013.html (2011 accessed 12 December 2024)."},{"key":"e_1_3_2_5_2","unstructured":"Padappayil RP Borger J. Ammonia Toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing 2023."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2023.2268981"},{"key":"e_1_3_2_7_2","unstructured":"Medical Management Guidelines for Ammonia. Agency for Toxic Substances and Disease Registry https:\/\/wwwn.cdc.gov\/TSP\/MMG\/MMGDetails.aspx?mmgid=7&toxid=2 (2017 accessed 12 December 2024)."},{"key":"e_1_3_2_8_2","unstructured":"Christian S Winklepleck D. Roommates of U.S. 40 Ammonia Leak Victims Speak Out. WTWO\/WAWV https:\/\/www.mywabashvalley.com\/news\/illinois-news\/roommates-of-u-s-40-ammonia-leak-victims-speak-out\/ (2023 accessed 12 December 2024)."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0b013e318159a44e"},{"issue":"19","key":"e_1_3_2_10_2","first-page":"35","article-title":"Anhydrous ammonia pulmonary toxicity: a significant farming hazard","volume":"5","author":"Waheed I","year":"2017","unstructured":"Waheed I, Fuller A. Anhydrous ammonia pulmonary toxicity: a significant farming hazard. Southwest Respir Crit Care Chron 2017; 5(19): 35\u201338.","journal-title":"Southwest Respir Crit Care Chron"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/jbcr\/irac142"}],"container-title":["Sage Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251327670","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X251327670","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251327670","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:18:42Z","timestamp":1767676722000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X251327670"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,17]]},"references-count":10,"alternative-id":["10.1177\/2050313X251327670"],"URL":"https:\/\/doi.org\/10.1177\/2050313x251327670","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"value":"2050-313X","type":"print"},{"value":"2050-313X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,17]]},"article-number":"2050313X251327670"}}