Case report: Acute respiratory distress syndrome and shock caused by
severe chlorine gas poisoning was successfully cured by venous-arterial
extracorporeal membrane oxygenation
Abstract
Objectives: To report a severe case of severe chlorine poisoning
inducing acute respiratory distress syndrome (ARDS) and shock required
venous-arterial extracorporeal membrane oxygenation (V-A ECMO). Design:
Case report. Setting: Pediatric intensive care unit (PICU). Patients: A
11-year-old boy who admitted to our PICU after inhaled chlorine
poisoning. Interventions: V-A ECMO. Measurements and Main Results: After
inhaling chlorine, the children quickly developed hypoxia, cyanosis and
unconsciousness. After high-condition mechanical ventilation, hypoxia
was only slightly improved for a short time, and then deteriorated
rapidly and shock occurred. The highest oxygen saturation index was
27.3, and the chest X-ray showed extensive diffuse interstitial
parenchyma changes. The oxygenation and circulation was recovered
quickly under ECMO. The children received methylprednisolone intravenous
injection for 3 days, the pulmonary lesions basically recovered 5 days
after onset. He was successfully removed from the ventilator 1 day after
the successful removal of ECMO. Follow-up 3 months after discharge
showed the pulmonary lesions were completely absorbed and there were no
other sequelae. Conclusion: Chemical pneumonia caused by chlorine
inhalation can lead to severe ARDS or even shock, but the prognosis is
often good. ECMO support should be considered when conventional
treatment is ineffective.