Capillary permeability Lewisite shock

Dermal or intravenous exposure to lewisite leads to local skin edema and pulmonary edema due to increased capillary permeability. The increased capillary permeability results in blood plasma loss and resultant physiological responses collectively referred to as lewisite shock . Lewisite shock may be likened to shock observed in severe bum cases. It has been hypothesized that functional changes in the lungs, kidneys, respiratory tract, cardiovascular, and lymphatic systems may be the result of a disturbance of osmotic equilibrium (Goldman and Dacre, 1989). 

Lewisite is readily absorbed from the skin, eyes, and respiratory tract, as well as after ingestion and through wounds. It causes blistering on the skin and mucous membranes on contact. After absorption, it causes an increase in capillary permeability, which produces hypovolemia, shock, and organ damage. Unlike the mustard agents, lewisite vapor or liquid causes immediate pain or irritation although lesions require up to 12 h to become full-blown cases. 

Lmge exposures to Lewisite can cause Lewisite shock due to increased capillary membrane permeability and subsequent protein and plasma leakage across the capillary membranes. As a result, patients suffer intravascular fluid loss, hemoconcentration, hypovolemia, and hypotension (8,24). Cutaneous exposures can produce localized edema and pulmonary edema secondary to damage at the alveolm - capillary membrane (8). 

Cardiovascular Lewisite shock due to increased capillary permeability and subsequent intravascular volume loss, hypovolemia and organ congestion... 

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