Ejaz Taymmia, Saadia Sheema, Akhlaq Safia, Aziz Adil, Ahmed Muhammad Arslan, Siddiqui Aisha Fareed
Department of Medicine, The Aga Khan University Hospital, Karachi, Pakistan.
Arch Acad Emerg Med. 2022 Feb 14;10(1):e15. doi: 10.22037/aaem.v10i1.1448. eCollection 2022.
On March 6,2020, chlorine gas leak was reported at Engro Polymer & Chemicals Plant in Karachi City, Pakistan. This study aimed to evaluate the clinical features and outcomes of patients who presented to emergency department (ED) following this event.
This retrospective cross-sectional study, evaluated the clinical features and outcomes (length of hospital stay, complications, and mechanical ventilation requirement) of patients presenting to ED of Aga Khan University Hospital, Karachi, Pakistan, with history of chlorine gas exposure at the Engro Plant from 6 March to 14 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 comorbid diseases. 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 hospitalization. 6 (15.8%) patients had repeat presentation requiring hospitalization or ED visit. 18 (47.4%) were managed with high flow oxygen therapy, 9 (23.7%) required non-invasive ventilation and one patient was intubated due to development of pneumo-mediastinum. Mean length of stay was 1.55 ± 1.58 days and no patients died. Presence of tachycardia was the only finding significantly associated with need for oxygen (p = 0.033) and non-invasive ventilation (p = 0.012).
The majority of patients presenting with acute chlorine gas exposure showed good clinical outcomes and rapid recovery, however, a high index of suspicion and vigilance should be maintained for complications such as pneumomediastinum and acute respiratory distress syndrome in these patients.
2020年3月6日，巴基斯坦卡拉奇市的Engro聚合物与化学品工厂发生氯气泄漏事件。本研究旨在评估该事件后前往急诊科（ED）就诊患者的临床特征及预后情况。
本回顾性横断面研究评估了2020年3月6日至14日期间，因接触Engro工厂氯气而前往巴基斯坦卡拉奇阿迦汗大学医院急诊科就诊患者的临床特征及预后（住院时间、并发症及机械通气需求）。
38例平均年龄为33.1±8.1岁的患者因接触氯气前往急诊科就诊（100%为男性）。4例（10.5%）患者患有合并症。最常见的症状为呼吸困难，33例（86.8%）患者出现该症状，其次为咳嗽，27例（71.1%）患者有此症状。13.2%（5/38）的患者胸部X线检查有浸润影，33例（86.8%）患者需要住院治疗。6例（15.8%）患者再次就诊，需要住院或前往急诊科。18例（47.4%）患者接受高流量氧疗，9例（23.7%）患者需要无创通气，1例患者因发生纵隔气肿而插管。平均住院时间为1.55±1.58天，无患者死亡。心动过速是唯一与吸氧需求（p = 0.033）和无创通气需求（p = 0.012）显著相关的发现。
大多数急性氯气暴露患者临床预后良好且恢复迅速，然而，对于这些患者，应高度怀疑并警惕纵隔气肿和急性呼吸窘迫综合征等并发症。
