Respiratory complications from tetraethylammonium ion; report of two deaths.

T HE tetraethylammonium ion has been used quite extensively since 1946, when Acheson and Moe1' 2 demonstrated its action as a blocking agent, effective at both sympathetic and parasympathetic ganglions. Earlier, Burn and Dalei and Hunt,4 had described the actions of certain quaternary ammonium bases which included the tetraethylammonium ion.* This drug has been used therapeutically with varying success in a variety of disorders, including thromboangiitis obliterans and arteriosclerosis obliterans,6-9 coronary heart disease,'0 hypertension and toxemia of pregnancy,"' 12 thrombophlebitis, Raynaud's phenomenon, trench foot and immersion foot,'3 peptic ulcer,4 '5 poliomyelitis,"6 herpes zoster and intercostal neuralgia.'1 Diagnostically, tetraethylammonium chloride has been employed in the evaluation of many acrovascular conditions 18-20 in the selection of patients with neurogenic hypertension for sympathectomy,2' and in the roentgen study of the small bowel.22 Reports of serious reactions from the use of tetraethylammonium chloride have not been numerous, but unpleasant side effects have somewhat limited its usefulness,23 as has the