Chlorine gas inhalation manifesting with severe acute respiratory distress syndrome successfully treated by high-volume hemofiltration: A case report

RATIONALE: There have been occasional reports of respiratory dysfunction associated with acute chlorine gas inhalation. However, management of acute chlorine-related inhalation injury is largely empirical, supportive, and sometimes challenging. PATIENT CONCERNS: A 43-year-old man was transferred to the emergency department because of accidental chlorine inhalation and rapidly progressive dyspnea. DIAGNOSES: The patient was diagnosed with acute respiratory distress syndrome due to chlorine gas exposure. INTERVENTIONS: Because this patient had failed on conventional treatments including mechanical ventilation and high-dose intravenous corticosteroid therapy, we applied high-volume hemofiltration (HVHF). OUTCOMES: The patient recovered quickly after four sessions of HVHF and was discharged uneventfully on day 28. LESSONS: HVHF is a potential method for improvement of chlorine-induced acute respiratory failure and worsening hypoxemia.