Introduction
Chlorine gas can damage respiratory tract mucosa directly. It can also
produce hypochlorous and hydrochloric acid with high oxidizing potential
which all cause unspecific cell damage in skin and mucosa [1]. Acute
chlorine poisoning refers to a systemic disease characterized by acute
respiratory damage caused by inhaling a large amount of chlorine in a
short period. Mild patients usually do not need to be hospitalized,
severe patients can be life-threatening due to larynx and epiglottis
edema, acute respiratory distress syndrome (ARDS), often need mechanical
ventilation, but rare of them need extracorporeal membrane oxygenation
(ECMO) support. The overall survival rate is high [2]. Shock, a rare
complication of chlorine poisoning, is reported to be caused by heart
failure secondary to toxic cardiomyopathy in some reports [3, 4].
Here, we reported a severe obese child with acute chlorine poisoning
whose oxygenation was unable to be improved by high-conditioned invasive
mechanical ventilation (MV) and soon developed non-cardiogenic
decompensated shock, and finally recovered via venous-arterial ECMO
(VA-ECMO) life support without obvious sequelae.