CHEST Guidelines-Extracorporeal-Membrane-Oxygenation-in-the-Treatme

Extracorporeal-Membrane-Oxygenation-in-the-Treatme

Pdf Summary

This report highlights a unique medical case dealing with acute elemental mercury inhalation toxicity leading to severe acute respiratory distress syndrome (ARDS) in a 56-year-old man working in a thermometer factory. ARDS, often resulting from rare inhalation injuries like mercury, causes severe respiratory failure. The standard treatments are limited in guidance due to the scarcity of such cases, thereby marking this report as significant.<br /><br />The patient experienced severe respiratory distress and was treated using venovenous extracorporeal membrane oxygenation (VV-ECMO), a form of life support providing prolonged cardiac and respiratory assistance. Simultaneously, dual-chelation therapy with succimer and dimercaprol was administered to enhance mercury excretion from the body. This combined treatment approach led to successful pulmonary recovery and prevented the development of neurological and renal complications commonly associated with mercury toxicity.<br /><br />At follow-up, the patient exhibited improved pulmonary function, resolved respiratory injury, and no long-term organ damage, demonstrating VV-ECMO's efficacy in managing severe ARDS following mercury inhalation. The report offers novel insights into ECMO's role not only in respiratory support but also highlights its interaction with mercury levels in the blood. While literature notes venoarterial ECMO's use in such poisoning cases, VV-ECMO's role remains less described.<br /><br />The study underscores ECMO's potential in treating toxin-induced respiratory injuries when combined with aggressive chelation therapy, advocating for its consideration in similarly severe cases. It expands the understanding of managing toxicologic emergencies, suggesting that centers equipped with ECMO capabilities are best suited for such complex cases. This case therefore adds valuable evidence to existing medical literature on managing severe inhalation injuries in occupational settings.

Keywords

acute elemental mercury inhalation

acute respiratory distress syndrome

ARDS

venovenous extracorporeal membrane oxygenation

VV-ECMO

chelation therapy

mercury toxicity

pulmonary recovery

occupational exposure

toxin-induced respiratory injuries