Rationale: There have been occasional reports of respiratory dysfunction associated with acute chlorine gas inhalation. However, management of acute chlorine-related inhalation injury is largely empirical, supportive, and sometimes challenging.
Patient concerns: A 43-year-old man was transferred to the emergency department because of accidental chlorine inhalation and rapidly progressive dyspnea.
Diagnoses: The patient was diagnosed with acute respiratory distress syndrome due to chlorine gas exposure.
Interventions: Because this patient had failed on conventional treatments including mechanical ventilation and high-dose intravenous corticosteroid therapy, we applied high-volume hemofiltration (HVHF).
Outcomes: The patient recovered quickly after four sessions of HVHF and was discharged uneventfully on day 28.
Lessons: HVHF is a potential method for improvement of chlorine-induced acute respiratory failure and worsening hypoxemia.