Clinical Features and Outcomes of Acute Chlorine Gas In-halation; a Brief Repor

On March 6th,2020, chlorine gas leak was reported at Engro Polymer & Chemicals Plant in KarachiCity, Pakistan. This study aimed to evaluate the clinical features and outcomes of patients who presented toemergency department (ED) following this event.

This retrospective cross-sectional study, evaluatedthe clinical features and outcomes (length of hospital stay, complications, and mechanical ventilation require-ment) of patients presenting to ED of Aga Khan University Hospital, Karachi, Pakistan, with history of chlorinegas exposure at the Engro Plant from 6th March to 14th March 2020.

38 patients with mean age of 33.1± 8.1 years presented to ED with history of chlorine gas exposure (100% male). 4 (10.5%) cases had comorbiddiseases. Most common presenting symptom was dyspnea, observed in 33 (86.8%) cases, followed by cough,seen in 27 (71.1%) subjects. 13.2% (5/38) patients had infiltration on chest x-ray and 33 (86.8 %) required hos-pitalization. 6 (15.8%) patients had repeat presentation requiring hospitalization or ED visit. 18 (47.4%) weremanaged with high flow oxygen therapy, 9 (23.7%) required non-invasive ventilation and one patient was intu-bated due to development of pneumo-mediastinum. Mean length of stay was 1.55 ± 1.58 days and no patientsdied. Presence of tachycardia was the only finding significantly associated with need for oxygen (p = 0.033) andnon-invasive ventilation (p = 0.012).

The majority of patients presenting with acute chlorine gasexposure showed good clinical outcomes and rapid recovery, however, a high index of suspicion and vigilanceshould be maintained for complications such as pneumomediastinum and acute respiratory distress syndromein these patients.