Intensive Care Implications

Chemical warfare agent exposure may give rise to a number of the previously mentioned syndromes that require medium-term or even long-term ICU treatment. These include pulmonary edema and adult respiratory distress syndrome. In the case of organophosphate exposure, there may be a possibility of developing the "intermediate syndrome"^[91] with repeat paralysis of the patient requiring several days of ventilation. Experience with organophosphate anticholinesterases in this area is lacking, although there is considerable evidence from pesticide poisoning.

Many of the infectious agents considered as biological warfare agents can give rise to infections that will cause an overwhelming inflammatory response and organ dysfunction. Although the management of the infections caused by biological warfare agents is the domain of the specialized physician, intensive care will be required for systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) cases.