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.