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Rationale <p>Hydrogen fluoride (HF) inhalation injury is a&#xa0;rare but life-threatening condition that can lead to chemical pneumonitis, acute respiratory distress syndrome (ARDS) and systemic fluoride poisoning. Currently, standardized treatment protocols for HF-induced ARDS are lacking and the optimal management strategy remains to be established.</p> Patient concerns <p>A&#xa0;middle-aged male patient was discovered after inhaling 53% hydrogen fluoride gas and transferred to our hospital within 5 h, presenting with respiratory distress, hypoxemia and diffuse pulmonary opacities on computed tomography (CT).</p> Diagnoses <p>Severe HF inhalation injury, chemical pneumonitis, severe ARDS, acute kidney injury, distributive shock and systemic fluoride toxicity with hypocalcemia.</p> Interventions <p>Urgent venovenous extracorporeal membrane oxygenation&#xa0;(VV-ECMO) with integrated continuous renal replacement therapy&#xa0;(CRRT), high-dose methylprednisolone, continuous calcium gluconate infusion, and electrolyte monitoring.</p> Outcomes <p>Oxygenation improved, pulmonary exudates resolved and the patient was weaned off ECMO. At 7‑month follow-up, lung lesions and renal function normalized with no long-term complications.</p> Lessons <p>Early VV-ECMO supports oxygenation when conventional therapy fails, while CRRT aids fluoride elimination. Timely multimodal intervention is critical for HF-induced ARDS and renal failure outcomes.</p>

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Hydrogen fluoride inhalation injury complicated by acute respiratory distress syndrome

  • 期刊论文

  • 发表日期：

    2026年5月13日

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  • Yuqin Chen,
  • Jianshi Chen

摘要

Rationale

Hydrogen fluoride (HF) inhalation injury is a rare but life-threatening condition that can lead to chemical pneumonitis, acute respiratory distress syndrome (ARDS) and systemic fluoride poisoning. Currently, standardized treatment protocols for HF-induced ARDS are lacking and the optimal management strategy remains to be established.

Patient concerns

A middle-aged male patient was discovered after inhaling 53% hydrogen fluoride gas and transferred to our hospital within 5 h, presenting with respiratory distress, hypoxemia and diffuse pulmonary opacities on computed tomography (CT).

Diagnoses

Severe HF inhalation injury, chemical pneumonitis, severe ARDS, acute kidney injury, distributive shock and systemic fluoride toxicity with hypocalcemia.

Interventions

Urgent venovenous extracorporeal membrane oxygenation (VV-ECMO) with integrated continuous renal replacement therapy (CRRT), high-dose methylprednisolone, continuous calcium gluconate infusion, and electrolyte monitoring.

Outcomes

Oxygenation improved, pulmonary exudates resolved and the patient was weaned off ECMO. At 7‑month follow-up, lung lesions and renal function normalized with no long-term complications.

Lessons

Early VV-ECMO supports oxygenation when conventional therapy fails, while CRRT aids fluoride elimination. Timely multimodal intervention is critical for HF-induced ARDS and renal failure outcomes.