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VOLUME 65 , ISSUE 4 ( October-December, 2023 ) > List of Articles


A Rare Case of Chlorine Inhalation-induced Severe Acute Respiratory Distress Syndrome: A Case Report and Review of Literature

Arjun Kumar, Ashok K Janmeja, Rohit Manchanda, Balbir Singh

Keywords : Acute respiratory distress syndrome, Case report, Chlorine inhalation, Corticosteroid, Ventilation support

Citation Information : Kumar A, Janmeja AK, Manchanda R, Singh B. A Rare Case of Chlorine Inhalation-induced Severe Acute Respiratory Distress Syndrome: A Case Report and Review of Literature. Indian J Chest Dis Allied Sci 2023; 65 (4):193-196.

DOI: 10.5005/jp-journals-11007-0096

License: CC BY-NC 4.0

Published Online: 26-03-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Chlorine (Cl2) exposure-induced acute respiratory distress syndrome (ARDS) is rarely reported in clinical practice. Here, we report a case of a 45-year-old male patient presented with complaints of sudden onset of cough and breathing difficulties, which started after accidental inhalation of fumes coming from bleaching powder. The patient developed chlorine inhalation-induced ARDS and severe hypoxemia. The patient was well managed with early systemic corticosteroids along with bronchodilator and other supportive care. Hence, supportive therapy along with early systemic corticosteroid can be helpful in moderate-to-severe chlorine inhalation-induced ARDS patients requiring mechanical ventilation support, if carefully selected.

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  1. Sexton JD, Pronchik DJ. Chlorine inhalation: The big picture. J Toxicol Clin Toxicol 1998;36:87–93. DOI: 10.3109/15563659809162593.
  2. Winternitz MC. Collected studies on pathology of war gas poisoning. New Haven, CT: Yale University Press; 1920. p. 3.
  3. Adelson L, Kaufman J. Fatal chlorine poisoning: Report of two cases with clinicopathologic correlation. Am J Clin Pathol 1971;56:430–442. DOI: 10.1093/AJCP/56.4.430.
  4. Nodelman V, Ultman JS. Longitudinal distribution of chlorine absorption in human airways: Comparison of nasal and oral quiet breathing. J Appl Physiol 1999;86:1984–1993. DOI: 10.1152/jappl.1999.87.6.2073.
  5. Kennedy SM, Enarson DA, Janssen RG, et al. Lung health consequences of accidental chlorine gas exposures among pulp mill workers. Am Rev Respir Dis 1991;143(1):74–79. DOI: 10.1164/ajrccm/143.1.74.
  6. Deschamps D, Soler P, Rosenberg N, et al. Persistent asthma after inhalation of a mixture of sodium hypochlorite and hydrochloric acid. Chest 1994;105:1895–1896. DOI: 10.1378/chest.105.6.1895.
  7. Guloglu C, Kara IH, Erten PG. Acute accidental exposure to chlorine gas in the Southeast of Turkey: A study of 106 cases. Environ Res 2002;88:89–93. DOI: 10.1006/enrs.2001.4324.
  8. Traub SJ, Hoffman RS, Nelson LS. Case report and literature review of chlorine gas toxicity. Vet Hum Toxicol 2002;44:235–239. PMID: 12136975.
  9. Babu RV, Cardenas V, Sharma G. Acute respiratory distress syndrome from chlorine inhalation during a swimming pool accident: A case report and review of the literature. J Intensive Care Med 2008;23:275–280. DOI: 10.1177/0885066608318471.
  10. Chen TF, Wang CH, Hermes GL, et al. Chlorine inhalation injury with acute respiratory distress syndrome treated by extra-corporeal membrane oxygenation system. Glob J Medical Clin Case Rep 2020;7:005-009. DOI: 10.17352/2455-5282.000079.
  11. Yadav AK, Bracher A, Doran SF, et al. Mechanisms and modification of chlorine-induced lung injury in animals. Proc Am Thorac Soc 2010;7:278-283. DOI: 10.1513/pats.201001-009SM.
  12. Akira M, Suganuma N. Acute and subacute chemical-induced lung injuries: HRCT findings. Eur J Radiol 2014;83:1461–1469. DOI: 10.1016/j.ejrad.2014.04.024.
  13. Katano T, Murao H, Kato T, et al. A case of acute inhalation injury caused by premeditated chlorine gas exposure. Respirol Case Rep 2021;9(5):e00743. DOI: 10.1002/rcr2.743.
  14. Swinarew AS, Stanula AJ, Gabor J, et al. The influence of chlorine in indoor swimming pools on the composition of breathing phase of professional swimmers. Respir 2020;21:88. DOI: 10.1186/s12931-020-01350-y.
  15. Evans RB. Chlorine: State of the art. Lung 2005;183:151–167. DOI: 10.1007/s00408-004-2530-3.
  16. Moloney ED, Griffiths MJ. Protective ventilation of patients with acute respiratory distress syndrome. Br J Anaesth 2004;92:261–270. DOI: 10.1093/bja/aeh031.
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