Complex Interactions between Chemical Pneumonitis, Pneumothoraces, and ECMO in Pediatric Hydrocarbon Poisoning: Use of TALC Pleurodesis

Hydrocarbon poisoning is one of the common accidental poisonings in children, which can present with a varied spectrum of clinical symptoms from drowsiness, mild cough, and vomiting to severe chemical pneumonitis that may need invasive ventilation and rarely extracorporeal membrane oxygenation (ECMO) for respiratory support.Pneumatoceles are a known complication of chemical pneumonitis and can pose risk of pneumothorax on mechanical ventilation.We report a 10-month-old female child who presented to the hospital with respiratory failure after accidental ingestion of turpentine oil.She was started on ECMO support given worsening oxygenation index and pneumothoraces on maximal lung protective strategies on mechanical ventilation.Venoarterial (VA) ECMO was weaned off and decannulated on day 7 of the therapy; however, because of ruptured pneumatocele and recurrent pneumothorax, she underwent talc pleurodesis, after which she was successfully discharged home.