Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case report
Key Clinical Message Although the symptoms of accidental chlorine inhalation are typically mild, severe exposure can result in acute respiratory distress syndrome (ARDS). We present a case of pediatric ARDS due to chlorine exposure in which lung lavage and exogenous surfactant were successful in avo...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-01-01
|
| Series: | Clinical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ccr3.9302 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832589890225700864 |
|---|---|
| author | Paola Papoff Benedetto D'Agostino Roberto Cicchetti Antonella Bitti Valentina Pennetta Elena Caresta |
| author_facet | Paola Papoff Benedetto D'Agostino Roberto Cicchetti Antonella Bitti Valentina Pennetta Elena Caresta |
| author_sort | Paola Papoff |
| collection | DOAJ |
| description | Key Clinical Message Although the symptoms of accidental chlorine inhalation are typically mild, severe exposure can result in acute respiratory distress syndrome (ARDS). We present a case of pediatric ARDS due to chlorine exposure in which lung lavage and exogenous surfactant were successful in avoiding more invasive and costly treatments. Abstract Chlorine inhalation as a result of swimming pool chlorination accidents is relatively common. Because symptoms are typically mild (cough and bronchospasm), complications such as severe acute respiratory distress syndrome (ARDS) are identified at a late stage, which places the patient's life at risk and necessitates highly invasive interventions. We present a case of severe ARDS in a 14‐year‐old boy following accidental exposure to chlorine powder. Upon arrival in the pediatric emergency department, the patient received oxygen administration, nebulized salbutamol, and intravenous steroids because of dyspnea and cyanosis. Despite this treatment, the patient's respiratory condition deteriorated. Early intubation and lung‐protective ventilation transitorily improved hypoxemia. Given the underlying pathophysiology of chlorine lung injury characterized by surfactant dysfunction, the boy was treated with repeated bronchoscopic lung lavages followed by exogenous surfactant (Curosurf 30 mg/kg total), 1 h after intubation and subsequently after 6 and 12 h, when he achieved a significant and stable reduction in ventilatory requirements. This case study illustrates the beneficial effects of target therapy with bronchoscopic lung lavage followed by exogenous surfactant in chlorine related ARDS to prevent more invasive and costly treatments. |
| format | Article |
| id | doaj-art-1a834c87b8294849a345cb2475aa12cc |
| institution | Kabale University |
| issn | 2050-0904 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj-art-1a834c87b8294849a345cb2475aa12cc2025-01-24T05:08:46ZengWileyClinical Case Reports2050-09042025-01-01131n/an/a10.1002/ccr3.9302Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case reportPaola Papoff0Benedetto D'Agostino1Roberto Cicchetti2Antonella Bitti3Valentina Pennetta4Elena Caresta5Pediatric Intensive Care Unit, Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome Rome ItalyPediatric Intensive Care Unit, Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome Rome ItalyPediatric Intensive Care Unit, Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome Rome ItalyPediatric Intensive Care Unit, Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome Rome ItalyPediatric Intensive Care Unit, Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome Rome ItalyPediatric Intensive Care Unit, Department of Maternal and Child Health and Urological Sciences Sapienza University of Rome Rome ItalyKey Clinical Message Although the symptoms of accidental chlorine inhalation are typically mild, severe exposure can result in acute respiratory distress syndrome (ARDS). We present a case of pediatric ARDS due to chlorine exposure in which lung lavage and exogenous surfactant were successful in avoiding more invasive and costly treatments. Abstract Chlorine inhalation as a result of swimming pool chlorination accidents is relatively common. Because symptoms are typically mild (cough and bronchospasm), complications such as severe acute respiratory distress syndrome (ARDS) are identified at a late stage, which places the patient's life at risk and necessitates highly invasive interventions. We present a case of severe ARDS in a 14‐year‐old boy following accidental exposure to chlorine powder. Upon arrival in the pediatric emergency department, the patient received oxygen administration, nebulized salbutamol, and intravenous steroids because of dyspnea and cyanosis. Despite this treatment, the patient's respiratory condition deteriorated. Early intubation and lung‐protective ventilation transitorily improved hypoxemia. Given the underlying pathophysiology of chlorine lung injury characterized by surfactant dysfunction, the boy was treated with repeated bronchoscopic lung lavages followed by exogenous surfactant (Curosurf 30 mg/kg total), 1 h after intubation and subsequently after 6 and 12 h, when he achieved a significant and stable reduction in ventilatory requirements. This case study illustrates the beneficial effects of target therapy with bronchoscopic lung lavage followed by exogenous surfactant in chlorine related ARDS to prevent more invasive and costly treatments.https://doi.org/10.1002/ccr3.9302acute respiratory distress syndromebronchoalveolar lavagechlorinepediatricpulmonary edemasurfactant |
| spellingShingle | Paola Papoff Benedetto D'Agostino Roberto Cicchetti Antonella Bitti Valentina Pennetta Elena Caresta Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case report Clinical Case Reports acute respiratory distress syndrome bronchoalveolar lavage chlorine pediatric pulmonary edema surfactant |
| title | Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case report |
| title_full | Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case report |
| title_fullStr | Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case report |
| title_full_unstemmed | Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case report |
| title_short | Bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure: A pediatric case report |
| title_sort | bronchoscopic lung lavage and exogenous surfactant successfully reverse respiratory failure after severe chlorine exposure a pediatric case report |
| topic | acute respiratory distress syndrome bronchoalveolar lavage chlorine pediatric pulmonary edema surfactant |
| url | https://doi.org/10.1002/ccr3.9302 |
| work_keys_str_mv | AT paolapapoff bronchoscopiclunglavageandexogenoussurfactantsuccessfullyreverserespiratoryfailureafterseverechlorineexposureapediatriccasereport AT benedettodagostino bronchoscopiclunglavageandexogenoussurfactantsuccessfullyreverserespiratoryfailureafterseverechlorineexposureapediatriccasereport AT robertocicchetti bronchoscopiclunglavageandexogenoussurfactantsuccessfullyreverserespiratoryfailureafterseverechlorineexposureapediatriccasereport AT antonellabitti bronchoscopiclunglavageandexogenoussurfactantsuccessfullyreverserespiratoryfailureafterseverechlorineexposureapediatriccasereport AT valentinapennetta bronchoscopiclunglavageandexogenoussurfactantsuccessfullyreverserespiratoryfailureafterseverechlorineexposureapediatriccasereport AT elenacaresta bronchoscopiclunglavageandexogenoussurfactantsuccessfullyreverserespiratoryfailureafterseverechlorineexposureapediatriccasereport |