Acute respiratory distress syndrome caused by demulsifier poisoning: A case report

BACKGROUND This case report emphasizes the potential pulmonary toxicity of demulsifier gas, which is a widely used chemical. To our knowledge, this is the first documented instance of acute respiratory distress syndrome (ARDS) induced by inhalation of demulsifier gas. This report underscores the need for increased workplace safety and awareness regarding health risks associated with demulsifiers, particularly in industrial settings. Timely diagnosis and management of ARDS are crucial for improving patient outcomes, thus making this report significant for clinical practice and occupational health literature. CASE SUMMARY We present a rare case of acute demulsifier poisoning leading to ARDS in a previously healthy 69-year-old man. He presented with chest discomfort, shortness of breath, and dyspnea following a 30-minute exposure to demulsifier fumes in a poorly ventilated area. Chest computed tomography revealed bilateral diffuse infiltrative shadows. Based on his exposure history and clinical findings, a diagnosis of ARDS due to demulsifier poisoning was confirmed. The patient required high-flow oxygen and intravenous norepinephrine upon admission and was subsequently intubated for mechanical ventilation. Following timely and effective multidisciplinary treatment interventions including emergency care, intensive care, and respiratory medicine, he achieved positive outcomes and was ultimately discharged. CONCLUSION This case underscores the critical importance of recognizing chemical exposure risks and their potential to cause severe respiratory complications.