• Tolusha Harischandra, Kapilani Withanaarachchi, Bhagya Piyasiri, Hesaru Wickramasuriya, Gihan Piyasiri, and Richard Firmin.
• Cardiothoracic Unit, Karapitiya Teaching Hospital, Galle, Sri Lanka.
• Perfusion. 2020 Sep 1; 35 (6): 543-545.

AbstractWhile there is evidence to support the use of extracorporeal membrane oxygenation in acute respiratory distress syndrome due to a variety of causes, its use in chlorine gas-induced acute respiratory distress syndrome has not been described in the English medical literature. We present a young girl who had severe acute respiratory distress syndrome following exposure to chlorine gas during the disinfection process at a swimming pool. She failed conventional management and underwent venovenous extracorporeal membrane oxygenation. Despite multiple infections and a pneumothorax, she eventually recovered. Chlorine gas was the first agent of chemical warfare which caused a massive death toll during the First World War. Even today, the chemical is produced in large quantities and the threat of a large-scale leak is ever-present from industrial accidents or terrorist attacks. The criteria to assess and manage chlorine gas-induced acute respiratory distress syndrome are likely to be the same as for other causes of acute respiratory distress syndrome and extracorporeal membrane oxygenation can be used successfully.

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