Acute respiratory distress syndrome from chlorine inhalation during a swimming pool accident: A case report and review of the literature

Journal of Intensive Care Medicine

Volumn 23, Issue 4, 2008, Pages 275-280

  Babu, Rajesh V ^a   Cardenas Jr , Victor ^a   Sharma, Gulshan ^a,b  

^a University of Texas Medical Branch School of Medicine   (United States)

^b UNIVERSITY OF TEXAS MEDICAL BRANCH   (United States)

Author keywords

Acute inhalation injury; Acute respiratory distress syndrome; Chlorine; Corticosteroids; Respiratory failure

Indexed keywords

BRONCHODILATING AGENT; CHLORINE; CORTICOSTEROID; LEVOFLOXACIN; METHYLPREDNISOLONE; PREDNISONE; SALBUTAMOL; TRIAMCINOLONE;

ACCIDENT; ADULT; ADULT RESPIRATORY DISTRESS SYNDROME; ARTICLE; BLOOD GAS ANALYSIS; CASE REPORT; COMPUTER ASSISTED TOMOGRAPHY; DIZZINESS; DRUG DOSE REDUCTION; DRUG MEGADOSE; DYSPNEA; EMERGENCY TREATMENT; FEMALE; FIBEROPTIC BRONCHOSCOPY; HUMAN; INHALATION; INTENSIVE CARE UNIT; INTUBATION; LUNG EDEMA; NAUSEA; OXYGEN THERAPY; PNEUMOTHORAX; PRIORITY JOURNAL; SURVIVAL; SWIMMING POOL; THORAX RADIOGRAPHY; TRACHEOSTOMY; TREATMENT OUTCOME; TUBE; VENTILATOR ASSOCIATED PNEUMONIA;

ACCIDENTS; CHLORINE; EMERGENCIES; FEMALE; HUMANS; INHALATION; METHYLPREDNISOLONE; RESPIRATION, ARTIFICIAL; RESPIRATORY DISTRESS SYNDROME, ADULT; SWIMMING POOLS; YOUNG ADULT;

EID: 48249105440     PISSN: 08850666     EISSN: 15251489     Source Type: Journal    
DOI: 10.1177/0885066608318471     Document Type: Article

References (25)

1. Winder C. The toxicology of chlorine. Environ Res. 2001 ; 85: 105-114.
2. Evans RB Chlorine: state of the art. Lung. 2004 ; 183: 151-167.
3. Sexton JD, Pronchik DJ Chlorine inhalation: the big picture. Clin Toxicol. 1998 ; 36: 87-93.
4. Agabiti N., Ancona C., Forastiere F., et al. Short term respiratory effects of acute exposure to chlorine due to a swimming pool accident. Occup Environ Med. 2001 ; 58: 399-404.
5. Martin JG, Campbell HR, Iijima H., et al. Chlorine-induced injury to the airways in mice. Am J Respir Crit Care Med. 2003 ; 168: 568-574.
6. Olin AC, Ljungkvist G., Bake B., Hagberg S., Henriksson L., Toren K. Exhaled nitric oxide among pulpmill workers reporting gassing incidents involving ozone and chlorine dioxide. Eur Respir J. 1999 ; 14: 828-831.
7. Rabinowitz PM, Siegel MD Acute inhalational injury. Clin Chest Med. 2002 ; 23: 707-715.
8. D'Alessandro A., Kuschner W., Wong H., Boushey HA, Blanc PD. Exaggerated responses to chlorine inhalation among persons with nonspecific airway hyperreactivity. Chest. 1996 ; 109: 331-337.
9. Mapp CE, Pozzato V., Pavoni V., Gritti G. Severe asthma and ARDS triggered by acute short-term exposure to commonly used cleaning detergents. Eur Respir J. 2000 ; 16: 570-572.
10. Schonhofer B., Voshaar T., Kohler D. Long-term sequelae following accidental chlorine gas exposure. Respiration. 1996 ; 63: 155-159.
11. Sheridan R. Airway management and respiratory care of the burn patient. Int Anesthesiol Clin. 2000 ; 38: 129-145.
12. Wang J., Zhang L., Walther S. Administration of aerosolized terbutaline and budesonide reduces chlorine gas-induced acute lung injury. J Trauma. 2004 ; 56: 850-862.
13. Gunnarsson M., Walther S., Seidal T., Lennquist S. Effects of inhalation of corticosteroids immediately after experimental chlorine gas lung injury. J Trauma. 2000 ; 48: 101-107.
14. Wang J., Winskog C., Edston E., Walther SM Inhaled and intravenous corticosteroids both attenuate chlorine gas-induced lung injury in pigs. Acta Anaesthesiol Scand. 2005 ; 49: 183-190.
15. Parimon T., Kanne JP, Pierson DJ Acute inhalation injury with evidence of diffuse bronchiolitis following chlorine gas exposure at a swimming pool. Respir Care. 2004 ; 49: 291-294.
16. Martinez TT, Long C. Explosion risk from swimming pool chlorinators and review of chlorine toxicity. Clin Toxicol. 1995 ; 33: 349-354.
17. 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.
18. Steinberg KP, Hudson LD, Goodman RB, et al. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med. 2006 ; 354: 1671-1684.
19. Bonetto G., Corradi M., Carraro S., et al. Longitudinal monitoring of lung injury in children after acute chlorine exposure in a swimming pool. Am J Respir Crit Care Med. 2006 ; 174: 545-549.
20. Thickett KM, McCoach JS, Gerber JM, Sadhra S., Burge PS Occupational asthma caused by chloramines in indoor swimming-pool air. Eur Respir J. 2002 ; 19: 827-832.
21. Lemiere C., Malo JL, Boutet M. Reactive airways dysfunction syndrome due to chlorine: sequential bronchial biopsies and functional assessment. Eur Respir J. 1997 ; 10: 241-244.
22. Nemery B. Late consequences of accidental exposure to inhaled irritants: RADS and the Bhopal disaster. Eur Respir J. 1996 ; 9: 1973-1976.
23. Gautrin D., Leroyer C., Infante-Rivard C., et al. Longitudinal assessment of airway caliber and responsiveness in workers exposed to chlorine. Am J Respir Crit Care Med. 1999 ; 160: 1232-1237.
24. Brooks SM, Weiss MA, Bernstein IL Persistent asthma syndrome after high level irritant exposures. Chest. 1985 ; 88: 376-384.
25. Nemery B., Hoet PHM, Nowak D. Indoor swimming pools, water chlorination and respiratory health. Eur Respir J. 2002 ; 19: 790-793.